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

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