Screening Athletes For Heart Defects

Almost weekly we read of another young athlete that suddenly collapses and in far too many cases dies of a "heart attack". The following are excerpts are from various articles including:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994446/

Example: "Shane del Rosario has died, nearly two weeks after suffering a heart attack, the UFC announced Monday. The 30-year-old Del Rosario, a professional MMA fighter since 2006. Official Statement: Shane Del Rosario had a catastrophic cardiovascular collapse at home on Tuesday morning. He was brought to the hospital in full cardiac arrest. Del Rosario’s management team released a statement saying doctors were looking at the potential that the fighter had a rare heart condition known as Long QT Syndrome that typically goes undetected until there’s a problem.

The goals of evaluating individuals for exercise and sports participation is crucial. The most important reason to screen for heart disease is to prevent sudden, unexpected death. Heart disease may also lead to sudden incapacity which may result in injuries, and pre-existing heart disease may be exacerbated by exercise. It has been estimated that there are 5 million active athletes at the high school, university, professional and master's levels in the United States.1 The sudden death rate among high school athletes is 1:100–200 000; among marathon runners 1:50 000; and among recreational joggers 1:15 000.2 Thus, athletic sudden cardiac death is a rare event.

“Sudden cardiac deaths in competitive athletes continue to be highly visible, compelling emotional events with significant liability concerns. These catastrophes are frequently subjected to intense public scrutiny largely because of their occurrence in young otherwise healthy-appearing individuals, including elite participants in collegiate and professional sports”

CAUSES OF SUDDEN DEATH IN ATHLETES
In athletes above the age of 35, especially men, the most common cause of sudden death is atherosclerotic coronary artery disease. In younger individuals atherosclerotic coronary artery disease is much less common and other diseases predominate. The most common cause of sudden death in young athletes is hypertrophic cardiomyopathy. The second most common is coronary artery anomalies, and the third is abnormal left ventricular hypertrophy.

RECOMMENDATIONS FOR SCREENING
Ideally screening should be done pre-participation by a physician trained in this activity, but other well-trained healthcare workers are acceptable as long as they do not have a conflict of interest. Screening should be done yearly just before training for the sports activity begins. The evaluation should include a history of symptoms suggestive of heart disease, a family history of premature death or specific cardiac diseases, and questions about substance abuse. The physical examination should include blood pressure, femoral pulses, auscultation of the heart in the standing position and inspection for Marfan syndrome features. There should be a low threshold for delaying clearance to play to evaluate further suspected cardiovascular disease.

I currently suggest and strongly recommend that each patient/athlete consult with a cardiologist regarding the above concerns. The heart matter can only be found with the special testing. One day all athletes will be required to comply with examinations including ECG, echocardiography and referral to a cardiologist.

Better to be healthy and safe ... than to ignore a hidden problem.

A Baby Whispers Her Thoughts

I found this "letter" buried deep in my files. With political views being cast both ways, I ask that an open mind read this from a different perspective. That being .... from the unborn child.

                                  *********************************************

   Oct. 5: Today my life began. My parents do not know it yet. I am as small as the pollen of a flower, but it is I already. I will be a girl. I will have blonde hair and blue eyes. Nearly everything is settled already, even that I shall love flowers.

Oct 19: I have grown a little, but I am still too small to do anything for myself. My mother does almost everything for me, though she still does not know that she is carrying me under her heart.
   But, is it true that I am not yet a real person? That only my mother exists? I am a real person, just as a small crumb of bread is still bread. My mother is, and I am.

Oct. 23: My mouth is beginning to open. Just think, in a year or so I’ll be laughing; later I’ll start to talk. My first word will be “Mama”.

Nov. 2: Today my heart began to beat. It will beat softly for the rest of my life. After many years it will tire and stop and I shall die.
   My arms and legs are taking shape, but I must wait a long time before these tiny legs will raise up to my mother’s arms; and before these tiny arms can conquer the earth and befriend people.

Nov. 12: Tiny fingers are forming. How small they are. One day I’ll stroke my mother’s hair with them.

Nov. 20: Only today the doctor told my mother that I am living here under her heart. How happy she must be. Are you happy, Mother?

Nov. 25: My mother and father are probably thinking about a name for me. They don’t know I’m a girl, so they are probably calling me “Andy”.  But I want to the called Shannen. I am growing so big.

Dec. 10: My hair is growing. It is as bright and shining as the sun. I wonder what kind of hair my mother has?

Dec. 13: I can almost see, though it is night around me. When mother brings me into the world, it will be full of sunshine and flowers.
   More than anything, I want to see my mother. How do you look, Mother?

Dec. 24: I wonder if Mother heard the delicate beat of my heart?
   Some children are born with sickly hearts, but mine is healthy. It beats so evenly ... tup-tup, tup-tup, you shall have a healthy little daughter, Mother.

Dec. 28: Today my mother killed me.

Belly Fat And Your Health

We are witnessing the ever threatening fear of ill health, especially osteoporosis, dementia, Alzheimer's disease, diabetes, colorectal cancer, metabolic syndrome, high blood pressure, and other health problems. This article is simple and direct enough to hopefully motivate some to consider immediate changes in their lifestyle. The alternative is serious health issues and all too often .... death.

Excess accumulation of belly fat is more dangerous than excess fat around your hips and thighs. Belly fat is associated with serious health problems, such as heart disease, stroke, and type 2 diabetes. Your genes can contribute to your being overweight and help determine where you carry this extra fat, but poor lifestyle choices are likely to worsen the issue.

Eating high-fat foods is not helpful, but excess calories of any kind can increase your waistline and contribute to belly fat. Still, there is no single cause of belly fat. Genetics, diet, age, and lifestyle can all play a role. Changing dietary habits can help you fight the battle of the bulge and fight belly fat: Read labels, reduce saturated fats, increase the amount of fruits and veggies you eat, and control and reduce your portions.

Excess calories -- whether from alcohol, sweetened beverages, or over-sized portions of food -- can increase belly fat. Our bodies need calories, yet gram for gram, alcohol has almost as many calories as fat.

Alcohol does seem to have a particular association with an increased waistline, though. In general, that’s because when you drink alcohol, your liver is too busy burning off alcohol to burn off fat, leaving you with a beer belly. Studies show that alcohol can cause you to feel hungry by affecting hormones that regulate a sense of satiety.

Researchers at Wake Forest University found that trans fats, which are created by partially hydrogenated oil, increase the amount of fat around the belly and redistribute fat tissue to the abdomen from other parts of the body. Trans fats may be found in such foods as margarine, pastries, cookies and crackers, and fried and convenience foods.

Green tea, in combination with exercise, could help you lose weight, according to the Journal of Nutrition. Researchers think substances in green tea known as catechins stimulate the body to burn calories and enhance loss of belly fat. Blueberries also show promise, albeit in rodents. In one study, rats bred to become obese were fed either a high-fat diet or a low-fat diet rich in blueberries. Rats fed a blueberry-rich diet had less abdominal fat.

Many fast food options are typically high-fat, calorie-dense foods that are eaten in large portions -- all of which contribute to over-consumption of calories, weight gain, and an increase in belly fat when eaten frequently. Many fast food restaurants don’t provide nutritional information, but studies have shown that when this is available, people tend to pick lower-calorie meals.

According to the American Heart Association, “soft drinks and other sugar-sweetened beverages are the No. 1 source of added sugars in the American diet.” Added sugars mean added calories – something you want to avoid to help with weight loss and cut down on belly fat. Yet, high-fructose corn syrup has gradually replaced refined sugar as the main sweetener in soft drinks and has been blamed as a potential contributor to the obesity epidemic.

Does switching to diet sodas help? Although some research has suggested that people who drink artificially sweetened sodas as part of a calorie-restricted diet do lose weight, other studies have suggested that diet soft drinks could even lead to weight gain. For now, there’s no conclusive evidence either way.

To trim your waistline, add whole grains to your diet. For example, choose brown or wild rice instead of white rice. Refined and other highly processed foods can contribute to weight gain and interfere with weight loss. A study in the American Journal of Clinical Nutrition showed that a calorie-controlled diet rich in whole grains can trim extra fat from the waistline of obese subjects.

Couscous, spaghetti, and corn flakes are made from refined grains (though whole grain options may be available). But popcorn is a whole grain food that can boost fiber. The best way to prepare popcorn is with an air-popper, which requires no oil for cooking. Read labels to see what oils have been added to microwave popcorn.

All else being equal, though, whole grains are better than refined grains because they tend to be high in fiber and take longer to digest. This satisfies your hunger better and helps lower blood glucose levels and reduce fat.

Overall, men tend to store fat in the abdominal area more than women do, thanks to sex hormone differences. Before age 40, women tend to store most of their fat in the hips, thighs, and buttocks. After 40, as estrogen levels drop, body fat is redistributed to the abdomen.

When you lose weight, you’re much more likely to lose it in your midsection. Losing weight on a well-balanced plan will melt body fat, including belly fat. The best way to decrease your waist size is through healthy eating and regular exercise.

Doing sit-ups, crunches, or other abdominal exercises will strengthen your core muscles and help you lose fat, but they don’t specifically work on belly fat. In other words, spot exercise won’t decrease belly fat. The only way to lose belly fat (or any kind of fat) is through dieting and exercise. Aerobic exercises, such as running, swimming, cycling, and tennis, are some of the best to help reduce body fat.

Belly fat appears to be especially bad for the heart. Studies have linked belly fat to heart failure, atherosclerosis, and other cardiovascular problems. It also has been associated with osteoporosis, dementia, Alzheimer's disease, diabetes, colorectal cancer, metabolic syndrome, high blood pressure, and other health problems.

Most scientific evidence suggests that a calorie-controlled diet rich in fruits, vegetables, whole grains, low-fat dairy, beans, nuts, seeds, lean meat, fish, eggs, and poultry is the foundation for a diet that provides all the nutrients you need while helping to whittle your waistline. Weight loss experts recommend combining this diet with 30 to 60 minutes of exercise most days of the week.

The above informational article is important .... read it more than once.