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Sudden Cardiac Death Among Athletes [Transcript]

Theodore Abraham, MD Theodore Abraham, MD, Is a cardiologist at Johns Hopkins. Watch the video

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Featuring Theodore Abraham, M.D., Director of the Hypertrophic Cardiomyopathy Clinic, Associate Professor of Medicine

Young athletes always feel they are invincible, yet we know that heart disease can kill athletes. We hear about this all the time in the newspapers and on TV. When I hear this, my heart breaks because I know these deaths can be prevented.

Eight years ago, I saw this young kid from Virginia, who had…who had been exercising in his college gym. He collapsed and experienced sudden cardiac death. He was saved because an alert janitor did CPR [cardiopulmonary resuscitation] immediately, called EMS [emergency medical services]. He was shocked out of a life threatening heart rhythm. This should have never happened because his dad died at age 34, several years prior to this, and if this kid had known that this was an inherited heart condition and had gotten evaluated for it, he would have never ended up in the situation he was in. He was lucky to be saved. He could have just as easily died from the event that he had at his college gym.

That event, led me to think that, if a kid like him, who was educated and had all the support – parental and healthcare support he needed – could be unaware of a dangerous condition like this, then kids in Baltimore city, who don’t have access to healthcare are probably in more danger. We decided that Hopkins had a role to play in this community by educating the community and offering services for screening some of the young kids in the community, which is what lead to the Heart Hype program being launched.

Heart Hype is a yearly program. It involves several hundred Hopkins and non-Hopkins volunteers at this point. We offer a questionnaire – a medical questionnaire – to all student athletes who come for an athletic event at Morgan State University. They then undergo blood pressure testing, weight testing, electrocardiogram, echocardiogram, and have a physical examination by a trained cardiologist or medical professional.

One thing we do differently than almost any program in the country is that, they get what we call the Heart Hype passport. As soon as they walk in, they do the questionnaire; they go through about five stations of examination. At each station, somebody marks out what they have and what they don’t have – what is normal and what is abnormal. At the very end, a fully board-certified cardiologist sits there and signs off on their report. I feel this is one of the few programs that do it real time. Most programs collect the images and they have someone looking at the images after the fact. We do it right on site. The folks that are suspicious or abnormal then talk more with that cardiologist, and depending on what the abnormality is, they get a plan of action.

With this program, under this Heart Hype protocol, we can capture about 80-90% of the potential conditions that can cause death in young people. The most predominant of those conditions is hypertrophic cardiomyopathy, and we’ve now screened over 1,000 students. We’ve found maybe 30%, so several hundred kids who have conditions which needed attention, like obesity, high blood pressure, which, if intervened upon at this early age could save them from heart disease and kidney disease even as early as their 20s or 30s.

We talk to them about these conditions which could potentially lead to sudden cardiac death. We offer them a brochure that has information about diet, healthy exercise, not smoking, drugs, and other things that would help them stay heart healthy for the rest of their lives.

At the Johns Hopkins Center of Excellence in Hypertrophic Cardiomyopathy, we have multiple specialists - from evaluation to treatment of the condition, but more importantly, it includes the athletic heart disease component; it includes the Heart Hype component. So under one roof, we have a whole swath of specialists who are dedicated and have a special interest in treating and saving lives from these conditions.

Communities – local communities – that are doing screenings are now using the Hopkins Heart Hype protocol to implement in their screening, and we hope that maybe in five years or so, we have several thousand athletes who have actually had this protocol and we’d be able to derive data from it that we’d be able to use for health policy planning or for future community screening to say, “How good is this protocol? What do we need to tweak to make this a better protocol to save lives?”