And the beat goes on

Thursday, March 1, 2007

Sudden death in sports is a term that is just too much hype. It’s a game. The sun will come up in the next morning. Life will go on.

Sudden death in medicine is final. One second the heart is beating normally and the next, it sits there jiggling like a bowl of Jell-O and the body just stops. So what good could ever come from the sudden death of Damien Nash, the Denver Bronco who collapsed after playing in a charity basketball game?

If you’re lucky and if you have sudden cardiac death on the streets of Seattle, where more people are trained in CPR than anywhere else in the country, your potential for survival is 30%. Same scenario in New York City and you’re out of luck with a 1% survival rate. If you collapse at O’Hare, you may even be luckier. With Automatic External Defibrillators (AEDs) around every corner, having a second chance at life can climb to 50%.

Sudden cardiac death occurs when the heart’s electrical system shorts out and the bottom part of the heart fibrillates and doesn’t allow the heart to contract and send blood to the body. In younger people common causes include cardiomyopathy, a condition where the heart muscle can become thickened and inflamed, abnormal coronary arteries (blood vessels to the heart itself) and ballooning of the aorta, the major artery that leads from the heart. In people older than 30, it is due to narrowing of the arteries to the heart, precursors to heart attack.

It happens rarely (about 1in 100,000 athletes) but when a young, supposedly healthy athlete dies in front of a crowd, we sit up and take notice. We ask questions, demand reforms and want to prevent even one more tragedy.

Prevention would be nice, but trying to identify athletes that are at risk isn’t very effective. Pre participation screening exams by a family physician may identify less than 15% of those at risk. And more aggressive testing of all athletes isn’t practical. Studies from France, Denmark and the International Olympic Committee in the last few months have all expressed frustration at the inability to lessen the death rate.

When the scientific community strikes out, it’s up to the regular citizens to take up arms. If we can’t prevent sudden death, then we have to treat it. Beating death isn’t easy, but Seattle has shown that it can be done.

If, tomorrow, you and your neighbor and the guys at work sign up for a CPR class at the Red Cross, the Heart Association, your local hospital, the Y or somewhere else in town, your own chance of surviving sudden death suddenly improves.

The answer to some problems comes in the form of community. Damien Nash was donating his time and efforts to help his brother’s heart foundation. We can honor Mr. Nash by learning how to help the guy next door.

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