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Heart of the Community: Barnes-Jewish West County Hospital Program Goes the Extra Mile to Save Young Athletes

November 22, 2010

While patients travel from many states and countries to receive expert care and treatment at Barnes- Jewish Hospital, its primary focus is making life better for the St. Louis community and surrounding areas. Barnes-Jewish West County Hospital plays an important role in this by offering many patients outside of the city an option that is closer to their homes.

At this facility, for example, patients with some forms of cancer can receive chemotherapy treatment, allowing them to save time traveling and allowing for more time to rest after treatment.

Another example is the Sudden Death in Athletes Prevention Program—the only program of its kind in our community—that is trying to stop a tragedy we seem to hear about too frequently. It’s a program made possible by gifts to the Barnes-Jewish Hospital Foundation.

A Frightening—But Preventable—Death

Student athletes running, jumping, sprinting and sweating during football, soccer or basketball practice seem to be in prime physical condition. But looks can be deceiving. One in 500 of these young athletes could be at risk from a dangerous heart condition called hypertrophic cardiomyopathy (HCM). They often have no idea until they drop to the ground during practice or a game and die from sudden cardiac arrest, leaving family, friends, teammates and coaches stunned.

“The first recognition of the problem is too often sudden death,” says Keith Mankowitz, MD, a Washington University cardiologist and director of the Hypertrophic Cardiomyopathy Clinic at Barnes-Jewish West County Hospital. “HCM is the most common cause of sudden death in young athletes under 35.”

As a doctor, an athlete and a soccer coach, Dr. Mankowitz is passionate about changing this statistic through better education of the medical community, parents and coaches, and better screening for this condition in young athletes.

Thickened Heart Raises Risks

HCM is usually an inherited condition that results in the thickening of the walls of the heart muscle. With HCM, the heart makes too much muscle tissue and, over time, the heart becomes twice as thick as normal. The disease can lead to heart failure, stroke or sudden death.

Some people with HCM live a normal life span and never experience symptoms. Others experiene such symptoms as chest pain, shortness of breath or fainting while they are teenagers or young adults. Dr. Mankowitz advises coaches and parents to watch athletes for symptoms that could signal HCM, rather than pushing them to “tough
it out” through exercise. “If an athlete has any symptoms, take the child to a physician qualified to look for HCM.”

A Mission for Better Education, Better Screenings—Charitable Gifts Make it Possible

Although school athletes are usually required to have a physical before they can play a sport, Dr. Mankowitz says these screenings are often inadequate.

“The health care providers usually have no formal training in how to screen for HCM and it can be difficult to detect in a routine physical. It’s important to take time to listen to a patient, go through a patient’s history, ask about symptoms and listen for heart murmurs or noise in the heart while the patient is lying down and standing up.”

Gifts to the Barnes-Jewish Hospital Foundation have allowed Dr. Mankowitz and his team to produce an educational website about sudden death in athletes, to speak at schools and to hold educational conferences for patients, families and coaches.

“My wish is that doctors, nurses and nurse practitioners learn how to do the best job they can in screening for HCM,” he says. “Together with parents, schools and coaches, we can do a better job of recognizing this killer by making sure an athlete gets a thorough evaluation before they play sports.”

He also recommends that teachers, coaches and student athletes know CPR and is encouraging schools to have an automated external defibrillator (AED) on site. An AED is a computerized medical device that can check and help regulate a person’s heart rhythm.

Expert Treatment Can Balance the Playing Field

The good news is not everyone with HCM is at high risk for sudden premature death. But an accurate diagnosis of the exact type of HCM is essential to know how to best manage it. The Hypertrophic Cardiomyopathy Clinic at Barnes-Jewish West County Hospital is the only clinic in the Midwest that focuses solely on HCM.

“Through treatment, we’re able to improve patients’ quality of life,” he says. “If patients are diagnosed with HCM and follow the medical advice we give them, they don’t have to die at a young age from this condition.”

Some patients can be treated with medication and by following precautions, such as avoiding certain sports and activities. If patients are at high risk for sudden death, they may need an internal cardioverter defibrillator (ICD) implanted, which monitors heart rhythm and delivers a regulating current if a life-threatening rhythm is detected.
In the rare instance where the heart has become extremely thick or when symptoms are not responding to medication, surgery may be required. There are two options offered at Barnes-Jewish West County Hospital: a myomectomy to reduce excess heart muscle tissue and allow blood to flow through the heart at a normal rate, or a
less invasive option that reduces muscle tissue by using alcohol to remove the blockage.

Both are complicated procedures requiring extensive experience. But the most important step in saving young athletes begins with education, Dr. Mankowitz says.

“By educating more people about HCM, improving screenings and promoting defibrillators, we can prevent more sudden death in young people.”

To support new and urgent needs like HCM prevention at Barnes-Jewish West County Hospital, please give to the Barnes-Jewish Hospital Foundation's Barnes-Jewish West County Hospital Leadership Fund (#7031) by clicking “Donate Now” above. If you have questions, please call David Sandler at 314-362-3499 or e-mail givingbarnesjewish@bjc.org.

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