Frequently Asked Questions
Q. What is Hypertrophic Cardiomyopathy?
A. Hypertrophic Cardiomyopathy or HCM is an abnormal thickening of the walls of the heart.
Q. What is the cause of Hypertrophic Cardiomyopathy?
A. The cause of Hypertrophic Cardiomyopathy is not yet known. In many cases the condition is inherited. In others there is either no evidence of inheritance or there is insufficient information about the individual's family to assess inheritance.
Q. What about the use of anabolic steroids?
A. The use of anabolic steroids to enhance athletic performance is a well-known practice among some high school, college, amateur and professional athletes. The effect of these drugs on the heart is becoming increasingly known. For example, animal studies have demonstrated a direct effect of anabolic steroids on the heart, possibly through specific steroid receptors on the heart. Among the effects seen in animals include greater heart weights and cardiac hypertrophy.
Case reports have linked anabolic steroids with increased left ventricular mass, Hypertrophic Cardiomyopathy, and sudden death in weightlifters and other athletes. Furthermore, two small studies of steroid-using athletes demonstrated a relationship between steroid use and impaired function and an increased size of the heart's chambers.
Q. How common is Hypertrophic Cardiomyopathy?
A. Hypertrophic Cardiomyopathy is a relatively uncommon heart disease. Its exact frequency is unknown. A paper by Dr. Barry Maron of the Minneapolis Heart Institute, estimated that between 1 in 500 and 1 in 1000 births could be affected by HCM. Based on these data we may estimate that as many as 300,000 people in the United States have HCM. In comparison Cystic Fibrosis has a prevalence of 1 in 3300. This means HCM is nearly 7 times more common than Cystic Fibrosis.
Q. What are the complications of Hypertrophic Cardiomyopathy?
Arrhythmias
Arrhythmias, irregularities of the heart beat, are a common complication. Symptoms such as palpitation may occur but not often. The arrhythmias called ventricular tachycardia (arising from the ventricles) or atrial fibrillation are particularly important.
Heart Block
The normal electrical signal may travel down to the ventricles slowly or may even be completely blocked.
Sudden Death
Persons with Hypertrophic Cardiomyopathy have an increased risk of premature sudden death, which may occur with little or no warning. Athletes are especially at risk, as the increase in physical activity can increase the likeliness of triggering the arrhythmias that can lead to sudden death.
Q. How many athletes actually die from Hypertrophic Cradiomyopathy?
A. According to the Center for Disease Control in Atlanta, 100,000 young athletes die each year from all cardio-vascular disorders, including Hypertrophic Cardiomyopathy, as a result of participation in sports. This is twice as many as die in auto accidents.
The major contributor to sudden death from cardiovascular causes during sport was Hypertrophic Cardiomyopathy. In a study of high school and college athletes, Hypertrophic Cardiomyopathy was the cause in 50 of 92 males and in 1 of 8 females with cardiovascular conditions. In another study, Hypertrophic Cardiomyopathy was cited in 48 of the 134 athletes. The second most common cardiovascular cause of death in the two studies was congenital abnormalities of the blood vessels servicing the heart (the coronary arteries), 16% and 13% in each study. A variety of rare cardiovascular conditions as well as several apparently "normal hearts" were represented in the remainder of the cases of sudden death.
Q. How is Hypertrophic Cardiomyopathy detected?
A. Currently, the diagnosis of Hypertrophic Cardiomyopathy is made by an ultrasound scan of the heart called an echocardiogram..
Q. Won’t the normal pre-participation physical conducted at the school detect Hypertrophic Cardiomyopathy?
A. Unfortunately, no. On occasion, a heart murmur may be heard using a stethoscope during a sports physical, however most murmurs are from benign causes. Detection of Hypertrophic Cardiomyopathy requires direct visualization of the heart with an echocardiogram.
Q. What is an Echocardiogram?
A. An Echocardiogram or Echo, produces a picture of the heart using sound waves. The excessive thickness of the muscle that occurs with Hypertrophic Cardiomyopathy can be easily measured. Additional equipment called "Doppler" ultrasound can produce a color image of blood flow within the heart and measure the heart's contraction and filling. Turbulent flow can be detected. Therefore an echocardiogram provides a very thorough assessment of Hypertrophic Cardiomyopathy.
Q. What if the echocardiogram on my son or daughter is positive.
A. A written report with the results of the screening echocardiogram will be sent to each parent, regardless if it is normal or abnormal. A separate letter will accompany a positive result, explaining the results, and what to do next. A copy of all positive results will also be provided to the athletic trainer and or athletic director of the school.
Q. What is the cost and who pays for the screening echocardiogram?
A. The cardiac screening (echocardiogram and EKG) performed by The Heart To Play costs just $75.00. This includes a review and report by a board certified cardiologist. The parents pay this for. The schools or districts do not pay for this service. For those families that are unable to afford the cost, scholarships are available.
Q. How do I get The Heart To Play to conduct a screening at my child’s school?
A. Forward this information to the athletic director and athletic trainer at your school. Have them contact us at (817) 849-8700. You may also wish to forward the information to the PTA/PTO and athletic booster clubs. We’ll work with your school to insure that have all the information necessary to begin a screening program for your athletes. You may also wish to contact us yourself.
Q. What is a screening EKG of the heart?
A. An EKG is a test that makes a tracing of the electrical activity of the heart. It takes only minutes to perform. Trained personnel attach several “leads” onto the chest and an EKG machine then makes a tracing. The exam is painless, and involves no radiation. As with the Echocardiogram, female students and student athletes are screened by females, and may wear a sports bra while being examined.
Q. Is there a difference between an echocardiogram and an EKG?
A. Yes. An echocardiogram is an ultrasound examination of the heart that examines the structures of the heart (walls, valves, and chambers) and how well they function. An EKG is an electrical tracing of the heart that examines the electrical activity of the heart. The two examinations compliment each other as they each evaluate for the risk factors of SCD that the other cannot.
