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Sports

 SPORTS MEDICINE // CARDIAC DEATH

By Mason Shieh

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The human body has incredible ways of communicating to us non-verbally when something is awry. We feel lightheaded when the brain isn’t receiving enough blood flow. Pain fibers fire anytime there is a break somewhere in our protective layer of skin. Irritating stomach contents trigger vomiting involuntarily to expel the contents. Much of the field of medicine is based on making decisions and corrective measures based on early warning signs that the body has communicated to us. Every person I care for in our Emergency Department comes in because some signal from their body worries them. They may have chest pain from a heart attack, a lung infection, or a bullet wound. Physicians decipher these symptoms and use their experience to intervene, bringing the body back to its normal function.



Unfortunately, the body is unable to warn us about certain conditions until it is too late. Sometimes the nonverbal cues the body sends are misinterpreted to be harmless and are ignored. The medical community recommends proactively checking for these hidden issues on everyone in the vulnerable age range. We routinely perform colonoscopies on healthy, asymptomatic people after age fifty so that colon cancers can be detected and treated in their early stages. The same is done for breast cancer using mammographies and cervical cancer using pap smears.


The condition that has only recently been getting attention is sudden cardiac death in young athletes. Teen athletes that have lived previously healthy lives are collapsing on fields and courts with no warning and often die within minutes. These incidents are especially frightening because of how young these kids are when it occurs, and the suddenness and finality of the outcome is devastating. The most difficult part for the medical community is that research shows many of the children have never shown any signs of warning. A select few may have complained of lightheadedness or dizziness previously, but these symptoms are commonplace when working out.


Currently, governing bodies only recommend screening by medical history and physical exam before participating in sports. The gold standard diagnostic workup is difficult to obtain and is rarely done. The primary care physician and health insurance would have to approve referral to a cardiologist. The cardiologist exam, EKG, and echocardiogram would cost thousands of dollars for each student. The overburdened healthcare system isn’t able to sustain that kind of workup for the millions of children that fall in this vulnerable age range. 


Along with many other concerned physicians in the sports medicine community, I have been investigating ways in which we can screen young athletes for these issues in an effective and sustainable manner. Perhaps having physicians go out to the schools to do screenings en masse can reduce costs significantly. The jury is still out on whether these abnormalities can yet be effectively screened with our available technology. It will take years and thousands of screenings to determine what’s effective and whether it can be extended to a nationwide scale.  My hope is that in the next few years, a protocol for cardiac screenings will be widely available and that many deaths of our nations young athletes can be prevented.



Mason Shieh, currently a Resident Physician in Emergency Medicine in New York, is a graduate from the University of California, Irvine School of Medicine, with an MBA from the University of California, Irvine Paul Mirage School of Business and a BSE from Duke University. His research revolves around sports medicineHe currently resides in New York.

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