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Doctors Say Not To Fear Activity But To Exercise Caution

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  • Doctors Say Not To Fear Activity But To Exercise Caution

    Copyright 2005 Daily Press, Inc.
    Daily Press (Newport News, Virginia)

    January 23, 2005 Sunday
    FINAL EDITION

    SECTION: A-SECTION; Pg. A11

    LENGTH: 769 words

    HEADLINE: DOCTORS SAY NOT TO FEAR ACTIVITY BUT TO EXERCISE CAUTION

    BYLINE: By ALISON FREEHLING Daily Press

    BODY:

    Sudden death in young athletes is so rare, kids shouldn't be afraid to be
    active. But knowing the subtle signs of trouble is important, too.

    When a young, seemingly fit athlete collapses and never gets up again, the
    reaction goes far beyond sadness -- to shock, disbelief and anxiety. And when
    four people younger than 25 die that way in a two-month period -- three of them
    within a week -- a better word is panic.

    But while Peninsula residents might think that severe heart problems are
    lurking everywhere, sudden death in children, teenagers and athletes in general
    is very uncommon, cardiologists say. Still, doctors say, parents and kids should
    be aware of symptoms that might hint at a hidden problem.

    Heart disease is, by far, the most common cause of sudden death in young
    people. Data are limited, but one study suggests that young athletes are about
    2.5 times more likely to die of heart problems than their counterparts who don't
    play sports. Even then, the estimated rate among teenage athletes is one death
    for every 100,000 to 300,000 competitors, the American Heart Association reports
    -- at most, 0.001 percent of the millions who play sports.

    "Far, far more teenagers die in car crashes," said Dr. Bertrand Ross, a
    pediatric cardiologist at Children's Hospital of the King's Daughters in Norfolk
    who has given talks on sudden deaths in children. "The psychological and social
    impact is just so devastating that it's well out of proportion to how often
    these deaths are actually happening."

    Many heart disorders don't show up during routine exams with a stethoscope.
    However, screening all children with more sophisticated tests isn't practical in
    terms of time or finances, doctors say, especially because even those tests won
    't pick up every problem.

    Children who have a family history of sudden, unexplained deaths or
    congenital heart disease are a different story. So are those who faint for no
    obvious reason or have dizzy spells during exercise. In those cases, parents
    should ask their family doctor for a referral to a heart specialist for an
    ultrasound and other tests.

    What's trickier for doctors is that some children have occasional heart
    palpitations or chest pain but have perfectly healthy hearts. So do many of the
    more than 20 percent of kids who pass out at some point during childhood for no
    apparent reason (such as seeing a big needle during vaccinations).

    If a parent is worried, there's no harm in asking about a specialist.
    Effective treatments for heart disorders include medicine, surgery and a small
    implanted machine called a defibrillator that keeps the heart from going into a
    wild and fatal rhythm.

    The most common cause of sudden cardiac death in young people is a condition
    called hypertrophic cardiomyopathy, or an abnormal thickening of the heart
    muscle. Less common conditions are an enlarged heart or problems with arteries
    that supply blood to the heart muscle.

    Overexertion isn't always the trigger of a fatal health crisis. In fact, some
    young people die while at rest. Dr. Hugh McCormick, medical director of
    cardiology at Riverside Regional Medical Center in Newport News, had a patient
    with an enlarged heart who was found dead in her bed.

    Vigorous exercise does play into some heart problems, though, especially if
    there's a blockage or other problem in the vessels that supply blood to the
    brain and body, McCormick said. In other patients, doctors never know what led
    to a collapse. All they can say is the time bomb that is a damaged heart simply
    exploded.

    "There's really a spectrum of circumstances," McCormick said. "What's
    happened here -- to have so many people die all in one time in one area -- is
    amazing."

    Deaths that occur in such clusters seem to be purely coincidental, Ross said.
    No studies have found factors that make one community more susceptible than
    another, he said. As for the extreme local temperature swings in the past couple
    of weeks, linking that to a potentially fatal strain on an athlete's body is
    pure speculation, McCormick said -- though that thought did cross his mind.

    Beyond heart disease, possible causes of sudden death include asthma, a brain
    aneurysm, sickle cell disease and hard blows to the chest.

    Scary stuff, but what doctors really don't want to see is a young person
    afraid of exercise or team sports. "The majority of children are going to be
    just fine," McCormick said. "In fact, staying active is about the best thing
    they can do for their hearts." *

    0.001

    The maximum percentage of teenage athletes who die of heart problems,
    according to the American Heart Association. The rate is about one in every
    100,000 to 300,000. *

    GRAPHIC: Mugs (b&w)
    Young local athletes who died recently Tito Bossman, 22, a former Tabb soccer
    player, died Jan. 15. Grace Lovegrove,18, a freshman runner at CNU, died Jan.
    12. Jackie Ward, 19, an HU runner, died Nov. 25. Joe Ward, 17, a Phoebus High
    baseball player died Jan. 15.

    LOAD-DATE: January 23, 2005

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