Heart failure amongst athletes always leads to questions

The recent tragic death of Hall of Fame basketball player and coach Anne Donovan has attracted the attention of many Connecticut Sun fans. What is most bewildering to many is how a highly-trained 56-year-old athlete passes away from heart failure.

The human heart consists of four muscular chambers: the right and left atria and the right and left ventricles. These chambers work in a coordinated fashion to pump blood from the right chambers to the lungs where it becomes enriched with oxygen and from the left chambers where blood is pumped to the brain and other organs.

Maintaining this coordination requires rhythmic stimulation from a network of nerves within the heart and blood vessels that nourish the heart muscle. Any malfunction of these components will lead to heart failure and subsequently deprive essential organs of needed oxygen.

The most common cause of heart failure in athletes is cardiomyopathy. This results from abnormalities that directly affect the heart muscle.

Similar to other muscles, the heart increases in size and efficiency as a response to the increasing demand of large muscles in athletes. This physiologic change in the heart muscle can hide other cardiac problems that affect the rhythm and blood supply to the heart muscle.

One way of detecting these changes in anticipation of a catastrophe is to perform advanced diagnostic studies including echocardiography that images the heart at rest and under stress.

“Structural changes of the heart in athletes such as enlarged chamber size and increased wall thickness are adaptive and physiological. However, some of these changes may overlap with cardiomyopathy,” reports Dr. Kai Chen, co-director of Sports Cardiology at the Calhoun Cardiac Center at UConn. “Early symptoms include an unexpected drop in performance, shortness of breath during exercise, chest tightness, and lightheadedness.“

Careful attention to cardiac symptoms during workouts can be lifesaving for athletes.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu

Beware of ticks at outdoor events

Athletes who compete in outdoor events in Connecticut must be especially mindful of ticks that carry a variety of bacterial infections. Although unlike viral infections, these conditions can be treated with antibiotics. The key is to identify and treat them quickly to avoid permanent injury.

Ticks are insects that survive by biting and digesting the blood of domestic and wild animals. They also bite humans and in turn transmit diseases from the animal to the human. As the population of potentially diseased animals has increased, so has the frequency of these illnesses.

Lyme disease is the most familiar and most common tick-borne bacterial infection. There are approximately 300,000 cases each year, most of these in the northeast.

Borrelia is the infectious agent in Lyme disease. Early symptoms are flu-like with joint pain, fever and a typical rash. If untreated the infection can spread to the nervous system. If infection is suspected, treatment with antibiotics within 72 hours of the tick bite can avoid Lyme disease entirely.

“Babesiosis and Anaplasmosis are other tick-borne diseases now being recognized more often,” reports Dr. Michael Rajkumar, a local infectious disease specialist. “These infections can cause severe illness and are sometimes fatal in certain populations such as infants, patients with immunodeficiencies and patients with certain blood disorders.“

Symptoms of Babesiosis are similar to Lyme disease but a persistent high fever and chills are an early hallmark. Treatment includes antibiotics combined with anti-malarial drugs.

Anaplasmosis, previously known as Ehrlichiosis, presents with symptoms one to two weeks after infection with a flu-like illness that can also lead to headaches and confusion if untreated.

Careful self-examination after competing or working out in tick-infested areas can be lifesaving.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu