When a high school football player died of sudden cardiac death, it shook a community. When an Olympic favorite in volleyball died in the same tragic way, it shook a world. Every year, 2,000 people under the age of 25 die from sudden cardiac arrest, estimates the American Academy of Pediatrics. Although sudden cardiac death is rare, it should be taken seriously. No one is ever too young to have heart problems. Vail Valley Medical Center (VVMC), along with a group of committed doctors are pooling their expertise and the latest technology in athlete screenings to prevent such a tragedy in our community.
In our state, the Colorado High School Activities Association (CHSAA) requires pre-participation physical exams (PPEs) for all high school athletes because they know one of the best preventions of sports injuries is finding hidden problems before they become major ones. It's not just important to screen for potential injury to limbs - it's also very much about the risk to life. Part of any thorough PPE exam is a check for a healthy heart.
"When it comes to sports, there are two focuses," said Cardiologist Lawrence Gaul of Avanti Cardiology, a division of the Vail Valley Medical Center.
One focus is on orthopedic screening. The other is screening of the cardio system and lungs to help detect any abnormalities. "The screening is to prevent sudden death, which is uncommon but catastrophic and devastating to a community," Gaulk said.
3D images of the heart
Although the odds are slim (1 in 100,000) a student athlete will die of sudden cardiac death, screening the heart through the PPE is the first step to keeping a student safe. Heart screenings and the use of EKGs can pick up on easily detectable and treatable heart-related issues as well.
"This is an opportunity to screen for common things like high blood pressure, which is important in the long-term, and also screen for the most uncommon things, such as sudden death in athletes," Gaul said.
Is there an easier, less costly way for doctors to test for faulty hearts?
Checking the heart doesn't have to be done in a clinic these days, at least not in Eagle County. VVMC's Avanti Cardiology recently purchased an echo machine, which makes checking a student athlete's heart much more convenient. An echo machine is a hand-held, cutting-edge machine made by GE about the size of a large flip phone. Inside, it has a screen, also much like a flip phone, with sleek, simple circular controls. But what it does is far more impressive than any phone - at least in the cardiologist's viewpoint. Only commercially available for two years, the tiny machine can take 3D images, similar to an echocardiogram, enabling a cardiologist to scan images of the heart, right then and there - no matter where you are.
Dr. Gaul and his Avanti staff recently helped assess the fitness of hundreds of area middle and high school athletes at Battle Mountain High School. They performed follow-up EKGs on dozens of the athletes, checking for heart abnormalities. But right there in the BMHS classroom, Dr. Gaul did heart screenings of any athlete with a murmur or other immediately noted inconsistency with the echo machine. He performed 50 screenings that weekend with the hand-held machine and picked up on six students who had significant hypertension - only one of which had any history of hypertension.
"The echo machine can eliminate something as unnecessary for follow-up, and pick up on rare types of congenital heart defects," Gaul said. And most importantly, Dr. Gaul's new tool conveniently allows us to say our student athletes are safe to play on.
Local freelance writer Connie Steiert was commissioned to write this story for the Vail Valley Medical Center.