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Jason Merrill
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January 19, 2010, ST. LOUIS – While the death of Chicago Bears’ defensive end Gaines Adams at age 26 comes as a shock, sudden cardiac death in young athletes happens in around 75 young athletes annually.

The most common reason – and the suspected cause of Adams’ death -- is hypertrophic cardiomyopathy (HCM).  Among cardiologists, it’s known as the most common cause of sudden death in young athletes.  It occurs in one in 500 individuals and is the most common genetic cardiovascular condition.

“It can be difficult to diagnose if you’re not familiar with the condition,” says Keith Mankowitz, MD, director of the hypertrophic cardiomyopathy clinic at the Washington University Heart Care Institute at Barnes-Jewish Hospital.  “It puts patients at increased risk of sudden death and they need specific management guidelines and treatment protocols in order to help these patients live a fruitful and long life.”

(Watch video on sudden cardiac death in young athletes here.) 

HCM is an inherited condition that causes the heart to thicken abnormally. In some families, HCM is passed on as an “autosomal dominant” trait, which means that if the gene for HCM is inherited from a single parent, the child will have the disease.  However, in almost half the patients with HCM, the genetic problem is not inherited at all, but occurs as a spontaneous mutation – in which case parents and sibs of the patient will not be at risk for this condition.

Several prominent young athletes are known to have died from HCM, including basketball players Hank Gathers, Reggie Lewis and Jason Collier, the NFL’s Thomas Herrion, the Blue Jays Joe Kennedy and the NHL’s Sergei Zholtok.  In addition, St. Louisan Damien Nash, who played running back at the University of Missouri and for the NFL’s Denver Broncos, is suspected to have died from HCM.

“Patients usually present with either chest pain or shortness of breath and some of them will present with palpitations,” says Dr. Mankowitz.  “It can present and look in many different ways, it has many different faces and the appearance of the heart can mimic other conditions.”

And for a young athlete who may be overexerting, Dr. Mankowitz says HCM can bring on ventricular arrhythmias that could be lethal.

“Other conditions such as coronary artery disease are not common for young athletes and this is a condition, that if they’re not counseled on it and at exercise activities if they overdo it they can be at risk for dying,” he says.

If a patient has a history of HCM in their family or suffering from the aforementioned symptoms, they should talk to their doctor.

“What they need is a history and physical exam, an electrocardiogram and an echocardiogram,” says Dr. Mankowitz.  “With those modalities we can make the diagnosis with certainty in the majority of cases.”

He adds that while HCM is not curable, it can be managed with medications like beta blockers and calcium blockers.