HIGH SCHOOL ATHLETICS: No easy answers in wake of well-publicized sudden deaths

SARATOGA SPRINGS -- Starting in early March, a cluster of high school athletes across the country suffered sudden deaths in roughly a two-week span, with a heart condition accounting for the cause of death in several of the instances. While ailments like the one that led to the death of Wes Leonard -- the Michigan basketball player who died of cardiac arrest brought on by the presence of an enlarged heart -- is not a new phenomenon, what to do at the high school-level to prevent similar future deaths is a tough question.

"What we try to do is make sure we're putting kids on the field safely," explained Chris Culnan, Shenendehowa's fourth-year athletic director. "The problem for us is that what we do right now wouldn't necessarily catch some of the things that we have seen happen across the country in regards to massive heart attacks or those kinds of things."

There are several reasons why there is not an easy solution, but the main reason seems to be the lack of a cost-friendly and efficient enough test to justify giving to each athlete given the small percentage of high school competitors who succumb to sudden death each year.

While statistics on the number of sudden deaths -- defined as a death occurring within 24 hours after the first sign of symptoms -- in high school athletes are hazy, most reference points agree the number is between 50-100 each year, though not all are attributed to heart-related conditions. Meanwhile, according to the National Federation of State High School Associations, roughly 7.5 million athletes competed in high school sports during the 2009-10 school year.


(That number contains some double-counting because of multiple-sport athletes.)

"A good majority of the population is not going to have these types of issues," said Rick Knizek, Shenendehowa's athletic trainer. "Yes, there are kids and adults who have this condition and they don't even know it ... [but], I think in the big picture, it's not something parents generally need to worry about."

But Knizek was once a first-hand witness to when an unknown heart condition almost took the life of an athlete. An assistant trainer at Union College in the mid-1990s, Knizek remembered a player on the men's basketball team collapsing during a practice and being rushed to the hospital. It was found that the athlete, who had no prior symptoms and was a heavy-minute player in his senior year, had an enlarged heart.

The athlete had an identical twin brother on the team who had never had a problem, but decided to get tested anyway -- he, too, was diagnosed with the same condition. The brothers elected to not finish their senior season after the scare.

"The problem is that unless you're being checked for that kind of condition specifically ... unless they're do electrocardiograms or something of that nature to check the heart specifically, you're going to miss those kinds of things," Knizek said.

The electrocardiogram is the main test used to check for things like an enlarged heart. The test measures the electrical activity within the heart to check for any abnormalities. However, such a test is not part of the standard physical.

Dr. Robert Nielson, who is certified in sports medicine and works out of Saratoga Hospital, said the main reason a test like an electrocardiogram is not given as part of a standard physical is because of logistics. Nielson, who oversees physicals at Argyle, Schuylerville and South Glens Falls, said schools simply don't have the resources to give the test to each student.

He said the test's imperfections -- it misses five percent of true positives and also sees 15 percent of its positive tests turn out to be incorrect -- have caused many to justify not giving the test, but it's not a line of thinking he agrees with. Nielson said that the lack of nearby places that can handle testing thousands of high school athletes is not a good enough reason for kids to go untested.

"You just need to have a place that will do them," Nielson said, comparing his preferred situation to how there are traveling vans that provide free mammograms for women.

"It should really be a no-brainer to screen a kid," Nielson argued, adding that, at a minimum, all student-athletes identified as being at risk for a heart-issue because of his or hers family health history should be tested every other year.

Nielson has a potential ally in Culnan, who answered with a quick and assertive "Yes!" when asked if the deaths in early March had worried him in regards to his athletes.

"I would love to have a more complete physical that really takes into consideration all aspects of a student-athlete's body," he said. "I think the more medicine and technology advances, (heart tests) can become more accessible to schools and it will be better for everyone."