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OLYMPIC BREASTROKE athlete has HCM

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  • OLYMPIC BREASTROKE athlete has HCM

    HEADLINE: CHANGE OF HEART;
    LEAVES SWIMMER;ON DECK OF POOL ITALIAN LAW PREVENTS ATHLETE FROM DEFENDING OLYMPIC BREASTROKE

    BYLINE: LAURA SPINNEY NATURE NEWS SERVICE


    Italy's Domenico Fioravanti won two gold medals at the Sydney Olympics in 2000, for the men's 100-meter and 200-meter breaststroke. But when he goes to Athens this year, it will be as a television commentator, not as a competitor.

    His fans will have seen him most recently in the reality TV show "La
    Fattoria," or "The Farm." In fact, he hasn't been in a swimming pool at all this year -- though not by choice. In January, the 27-year-old was diagnosed with an inherited heart condition called hypertrophic cardiomyopathy, or HCM, and, under Italian law, he was forced to retire from competitive sport.

    Fioravanti suffers from the same genetic problem that killed Cameroonian
    soccer player Marc-Vivien Foe in June 2003 while he was playing in the
    Confederations Cup semifinal against Colombia, followed seven months later by Hungarian Miklos Feher, who died while playing for Portuguese soccer team Benfica.

    Both men died on the pitch -- suddenly, and in front of the cameras. Even
    though Fioravanti knows he has the same condition and is well aware of the risks, his family is campaigning for a relaxation of the Italian law. They want him to keep on swimming or at least to have the option.

    HCM is the leading cause of sudden death in people under the age of 30. It
    is caused by the accumulation of an abnormal protein inside sarcomeres, which
    are a basic component of heart muscle cells. This causes the cells to grow too
    large and in a shambolic fashion, particularly around the left ventricle. As the
    muscles thicken, the heart can develop an irregular beat and runs the risk of
    stopping completely. About 0.1 percent to 0.2 percent of the world's population
    has HCM. Each year, about 1 percent of these die. The extra strain of excessive
    exercise is thought to trigger sudden death in people with the underlying
    condition.

    Doctors can diagnose HCM through imaging studies, treat it with drugs or
    surgery and implant a defibrillator to kick-start the heart back into action
    should there be a major problem. But it is still difficult to assess the risk of
    sudden death in any given patient. Fioravanti's frustration stems from this
    final fact. To all appearances, his condition is mild.

    "At this point, I could state that he has a low probability of dying
    suddenly, even doing active sport," says Franco Cecchi, the cardiologist at the
    University of Florence who confirmed his diagnosis. Yet in Italy, the mere
    confirmation of the condition means that Fioravanti is banned from competitive
    sport.

    In Italy, uniquely, athletes are required by law to get an annual fitness
    certificate before being allowed to take part in any competitive event. As part
    of this assessment they are given an electrocardiogram, or ECG, and questioned
    about their family history. If there is a suspicion of disease, they go on to
    have an echocardiogram, or echo -- an ultrasound scan of the heart and valves,
    which provides information about muscle thickness and the size of the heart's
    chambers. If this shows an abnormality, the athlete is automatically
    disqualified -- unless the sport is considered low risk, such as snooker or
    archery. If an athlete sneaks through the system and goes on to die while
    playing, the doctor who signed the authorizing certificate can be held liable if
    found negligent.

    Even if the issue of diagnosis can be cracked, it still leaves policy-makers
    and athletes with the dilemma of what to do with the information. One case
    frequently discussed by doctors concerned about this issue is that of Nicholas
    Knapp. A talented 17-year-old basketball player, Knapp had already been offered
    a sports scholarship at Northwestern University when his heart stopped at the
    end of a game in 1994. He was resuscitated, diagnosed with HCM and surgically
    implanted with a defibrillator. Nevertheless, he accepted the sports
    scholarship. The university allowed him to keep the scholarship, but barred him
    from playing intercollegiate basketball on medical grounds.

    A lengthy court battle ensued, in which Knapp argued that the choice was
    his, even if by playing he risked death. Northwestern's decision was eventually
    upheld, but Knapp was free to enroll in another university's basketball program,
    and did so. Three years after his first cardiac arrest, he suffered an episode
    of tachyarrhythmia -- an abnormally fast and irregular heartbeat. His
    defibrillator discharged, probably preventing a second arrest and saving his
    life.

    Since Knapp's case, it has been hard for athletes with a known condition to
    play competitively in the United States.

    But 10 years on, there are still no formal laws to govern these decisions,
    only guidelines. HCM patients had to wait until this June for a guide on
    participating in recreational sports. The American Heart Association recommends
    that people avoid burst activities such as sprinting, and rates the advisability
    of different sports for people with different conditions. Swimming is listed as
    "probably permitted" for HCM patients -- although this is not meant to apply to
    athletes at the Olympic level.

    GRAPHIC: Doug Mills/Associated Press
    Italian swimmer Domenico Fioravanti, left, celebrates winning the gold medal in
    the men's 200-meter breaststroke with teammate Davide Rummolo, who captured the
    bronze medal in the 2000 Summer Olympics in Sydney.
    Knowledge is power ... Stay informed!
    YOU can make a difference - all you have to do is try!

    Dx age 12 current age 46 and counting!
    lost: 5 family members to HCM (SCD, Stroke, CHF)
    Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
    Therapy - ICD (implanted 97, 01, 04 and 11, medication
    Currently not obstructed
    Complications - unnecessary pacemaker and stroke (unrelated to each other)

  • #2
    Re: OLYMPIC BREASTROKE athlete has HCM

    Lisa-
    Thanks for sharing that with us
    RONNIE

    Comment


    • #3
      Re: OLYMPIC BREASTROKE athlete has HCM

      And that’s why I can no longer compete in the Olympic Games. I wanted to be the oldest competitor too. My specialty was the Javelin Catch, but I was also thinking of going out for the Hammer Catch and the Shot Put Catch.

      I had given up all hope of competing in the Archery Catch – I just didn’t think my scooter could keep up. Maybe if I got an off-road motorbike? Nagh, by the next Olympics I’ll be seventy-eight – let the young bucks have a shot at it.

      And so ends the illustrious/hilarious career of a super/stupor athlete.
      Burt

      Comment


      • #4
        Re: OLYMPIC BREASTROKE athlete has HCM

        Burt you make me laugh even at 5:15!

        Last night there was an American swimmer (woman) about whom the anouncer said, "...because of her heart condition she has to have a defribrilator nearby at all times, especially when she compeats." Did anyone else hear that? I wonder what her condition is?

        Leon
        God Squad co-moderator
        Nothing is as gentle as strength and nothing is as strong as gentleness

        Comment


        • #5
          Re: OLYMPIC BREASTROKE athlete has HCM

          Already checked that out - she had a radoi frequency ablation - I would suspect she had WPW as it is easily correct with this procedure.

          Lisa
          Knowledge is power ... Stay informed!
          YOU can make a difference - all you have to do is try!

          Dx age 12 current age 46 and counting!
          lost: 5 family members to HCM (SCD, Stroke, CHF)
          Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
          Therapy - ICD (implanted 97, 01, 04 and 11, medication
          Currently not obstructed
          Complications - unnecessary pacemaker and stroke (unrelated to each other)

          Comment


          • #6
            Re: OLYMPIC BREASTROKE athlete has HCM

            Hi everyone:

            I also heard the commentators talking about the swimmer who needed a defibrillator, and was intrigued so I did some checking. The reports are somewhat confusing (one reported that she was diagnosed with radio frequency ablation and fortunately did not have the more serious Long QT syndrome) but I think that it's a case of Long QT. The swimmer is Dana Volmer from Texas.

            When I mentioned it to Olivia's EP yesterday, she said that Long QT has four different trigger types, one of which is set off by sudden exposure to water....she figured that they could safely rule out that type for Volmer. :P

            Have a great day, everyone.

            Abby

            Comment


            • #7
              Re: OLYMPIC BREASTROKE athlete has HCM

              Sounds like the Italians have it right.
              Sorry Burt, but the Javelin catch has already been done.
              Ever see that guy on TV who actually did get hit with the javelin while he was officiating.
              Every great thing that has ever happened since the beginning of time has started as a single thought in someones mind.
              So if you are capable of thought then you are capable of great things
              Good luck and stay well.
              Glen

              Comment


              • #8
                Re: OLYMPIC BREASTROKE athlete has HCM

                Originally posted by Glen Beamish
                Sounds like the Italians have it right.
                Respectfully disagree

                Comment


                • #9
                  Re: OLYMPIC BREASTROKE athlete has HCM

                  It is always great to agree to disagree -

                  In Italy they have very few deaths on the athletic field - the leading cause of SD in Italy is ARVD - as it is the hardest to catch on Echo/ECG.

                  The debate continues - but maintaining life will always be the "gold metal".

                  Lisa
                  Knowledge is power ... Stay informed!
                  YOU can make a difference - all you have to do is try!

                  Dx age 12 current age 46 and counting!
                  lost: 5 family members to HCM (SCD, Stroke, CHF)
                  Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
                  Therapy - ICD (implanted 97, 01, 04 and 11, medication
                  Currently not obstructed
                  Complications - unnecessary pacemaker and stroke (unrelated to each other)

                  Comment


                  • #10
                    Re: OLYMPIC BREASTROKE athlete has HCM

                    The Italians have it wrong. Unless someones choices physically harm another, they are just that (someones choice).. not the choice of the Govt, etc. I'm happy for the US athlete that chooses to live and compete (and is smart enough to keep a defib close by). I'm also sorry for the poor Italian that can't compete for his country. Maybe he will move to the US? All of life is about choices, some choose to live motivated to avoid problems, other are motivated to succeed.

                    Comment


                    • #11
                      Re: OLYMPIC BREASTROKE athlete has HCM

                      He would not pass the USA physical for participation at the olympic level in all likelyhood. There is an issue about liability. Just because someone wants to do something and feels that they can does not take away the liability to those who let that person participate when they know the risks.

                      I know we do not see eye to eye on this one Celtic - again I respect your opinions.

                      Best to all,
                      Lisa
                      Knowledge is power ... Stay informed!
                      YOU can make a difference - all you have to do is try!

                      Dx age 12 current age 46 and counting!
                      lost: 5 family members to HCM (SCD, Stroke, CHF)
                      Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
                      Therapy - ICD (implanted 97, 01, 04 and 11, medication
                      Currently not obstructed
                      Complications - unnecessary pacemaker and stroke (unrelated to each other)

                      Comment


                      • #12
                        Re: OLYMPIC BREASTROKE athlete has HCM

                        Sometimes it is not all about physical pain. I believe it would be more painful for my son or daughter to die in a basketball game because they did not heed the precautions. Than to have them beat me to a bloody pulp.

                        A tragedy like this affects everyone involved. I believe it to be a crime to knowingly take on that risk and make others suffer just for the sake of a game. I've run calls like this as an EMT and I live with them everyday.

                        I also know what it is like to be limited in what I can or can't do. Because, of my AICD I am not allowed to drive an ambulance. To the average person it doesn't sound like much but as a person in EMS it is a right of passage. Could I fight this yeah and probably could even win but I don't because I couldn't live with myself if my defib ever fired on a call.

                        Just as a side note you can live your life to its full possiblities without endangering yourself or others physically or emotionally.

                        Mary S.

                        Comment


                        • #13
                          Re: OLYMPIC BREASTROKE athlete has HCM

                          People who have seizures, by law are not allowed to drive until they can prove they no longer have them or have them under control via meds.
                          A lot of them probably think their right to choose has been infringed on also.
                          Every great thing that has ever happened since the beginning of time has started as a single thought in someones mind.
                          So if you are capable of thought then you are capable of great things
                          Good luck and stay well.
                          Glen

                          Comment


                          • #14
                            Re: OLYMPIC BREASTROKE athlete has HCM

                            Lisa's primary reason for posting this is "Knowledge is power ... Stay informed! "
                            Her secondary reason was to see if Darren was paying attention.
                            I believe in Liberty and personal responsibility. Therefore, I agree with Darren. However, I think you have to be a friggin idiot to compete in College/Olympic/professional sports with an HCM diagnosis (much the same as my being against motorcycle helmet laws, but believing that anyone who rides a motorcycle w/o a helmet is out of their mind).
                            Fx

                            Comment


                            • #15
                              Re: OLYMPIC BREASTROKE athlete has HCM

                              Well,

                              If you ride your motorcycle without a helmet, compete in a marathon with HCM, or do any of the other countless idiotic things in the world could you save them til the end of my shift!

                              Oh well, just adding a little humor to it.


                              Mary S.

                              Comment

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