Newspaper article

I have posted before and am 50 years old.  I have had PVCs since I was 19 years old.  I am on 25 mg of atenelol since 30 and .25 of alprazolam since the same.  I have undergone tests (MANY) and have been told that other than borderline high cholesterol (hereditary) that I have a structurally normal heart and should not worry about my PVCs. I recently had an echo and there was nowhere in the report that mentioned my EF, and I still can't figure that one out.  I have had episodes of thousands a day.  Then I can go for weeks or months with hardly any.  My question: I picked up the newspaper today and there
was an article about the soccer players dying of abnormal heartbeats!
One was 22 and, I believe, one was 24 or so. They collapsed on the
field. These are trained athletes who were known to have abnormal
heartbeats. No doubt they were told "exercise helps" and with
their "structurally normal hearts, they are benign." They said
frequent screening with an echo might have prevented this......What?
What are they looking for on an echo that needs to be done frequently?
What is a trained athlete doing dropping dead from abnormal
heartbeats?  How can we be told the same won't happen to us?  I do not understand how these people are so different than me, except that they exercise regularly.

[Michael J. McWilliams, M.D.]

What are they looking for on an echo that needs to be done frequently?
What is a trained athlete doing dropping dead from abnormal
heartbeats?  

I can understand why this concerns you.  I actually don't watch mainstream news because I think that their ratings thrive on panic.  I am not sure what to say without knowing what their diagnosis was and I am not sure that you can draw conclusions about yourself just because they had extra beats.

Some physicians do not report EF numbers, they will say things like normal, upper limit of normal, moderate severe, severe, or mild.   There may be words like that on your echo report referring to your EF.

For causes of sudden death in the young, the most common causes are hypertrophic cardiomyopathy, anomalous coronary arteries, long QT syndrome --no one on the list is PVCs in a structurally normal heart.  

How can we be told the same won't happen to us?

There are no guarantees in life and despite our best efforts, there are going to be people that die suddenly.  The absolute numbers are very low.  The probability of dying from other causes are much higher.  If you are really worried, talk to your doctor.

I hope this helps.

[ireneo]

I've read similar articles but for the life of me can't remember the name of the arrhythmia involved. It wasn't your run-of-the-mill PVC's. I'd have to research it a bit.I'm sure the doctor will know for sure.It seems to be a quiet undiagnosed arrhythmia in young folks that shows up unexpectedly in athletes. Now my curiosity is stirred up. Gotta go look.

[kitcurious]

long Qt syndrome is one thing that will cause that.

[pugfriend]

Thank you for asking this question. I also read the article and the same thought crossed my mind. In fact, this is the reason I no longer exercise very hard as it seems to bring on PVC's or what ever I have.  I need to lose weight but am afraid to exercise.  Why the mixed message?   Thanks again. Hope we get a reasonable answer.

[deedle1976]

Published in a polish medical journal this month:

Sudden death in competitive athletes
In athletes under the age of 35 years the incidence of sudden death is low, most causes to be due to ventricular arrhythmias, usually provoked by exertion, and nearly always occur in the presence of structural heart disease or abnormalities in the conduction system. The most common structural disease is hypertrophic cardiomyopathy followed by coronary artery anomalies, idiopathic dilated cardiomyopathy, arrhythmogenic right ventricular dysplasia, aortic stenosis, myocarditis, the Wolff-Parkinson-White syndrome, and long QT syndrome. The evaluation of athletes with symptoms of cardiac arrhythmias, syncope, family history of sudden death require a complete cardiac workup. If they have documented hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, idiopathic dilated cardiomyopathy, long QT syndrome, family history presentation with sudden death, and septal thickness greater than 20 mm competitive athletics are generally prohibited. In athletes with asymptomatic bradyarrhythmia, supraventricular tachycardias and atrial premature contractions without structural heart disease all competitive sports are allowed if heart rate in bradyarrhythmia appropriately increases with exercise. Athletes with premature ventricular contraction, nonsustained ventricular tachycardia and non structural heart disease are without athletic restriction as long as the arrhythmia does not worsen on exertion and cause dyspnea, presyncope or syncope.

[deedle1976]

Also from the medical journal "heart"

Sudden cardiac death in young athletes.

"Most cases of sudden cardiac death in young athletes (<35 years) are caused by inherited cardiomyopathies, notably hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy."

[deedle1976]

Last one!
Although there are lots of articles on this subject that agree that athletes who drop dead already have heart disease.

"Sudden cardiac death in a young athlete is a tragic and marking event, even though the media attention it gets is more important than its incidence (1-2/100000 per year). The main etiology is hypertrophic cardiomyopathy, followed by coronary artery anomalies. Sometimes signs of myocarditis are found at autopsy"

[frenchie47]

Hi~
I too always research articles such as this for the same reason.  We are told our hearts are fine, then some young athlete falls over and dies.  Hopefully this piece from an article I found will help ease your mind.  He died of a herediatary heart disease known as arrhythmogenic right ventricular cardiomyopathy.  
What I wonder is why on earth was that not caught during his routine physicals!  Wouldn't this be picked up on an echo?   How on earth could they miss that.
Frenchie  (see below, I copied and pasted from the article)

Doctor Francisco Murillo reported that Puerta had suffered multiple organ failure and irreversible brain damage as a result of multiple prolonged cardiac arrests due to an incurable, hereditary heart disease known as arrhythmogenic right ventricular cardiomyopathy.[9] There is no official word on whether he had ever been equipped with an implantable cardioverter defibrillator. Puerta's premature death from heart problems is similar to those of Marc-Vivien Foe, Matt Gadsby, Miklos Feher and Serginho, all of whom collapsed whilst playing in football matches.

[pugfriend]

The Dr. on CNN made a comment this morning about the sudden death of athletes. He said otherwise benign arrythmias can become deadly after vigorous exercise such as what athletes do.They said because their bodies are deprived of oxygen and without the reserve to fight off the attack.  The comment "otherwise benign" caught my attention.  They also said doctors still recomend 30 min of exercise a day because the benifits outway the risks.  I am still getting mixed messages about those so called benign arrythmias.  

[RNRita]

I have read a lot of articles about this over the years and it never bothered me because I certainly am no athlete.  But I tried to start an exercise program due to gaining a few pounds and wanting to be in better shape.  I went on a lousy treadmill and when I put it on incline, I felt horrible. I started getting PVCs (which I hadn't had for about 3 weeks), and my chest felt weird.  I was wondering if I was just panicking.  I'll never know because when this starts to happen, I stop.  Anyway, I believe athletes undergo extensive physicals before they can participate.  So, then, if they are fine......why....?  It is just so frustrating.

[wmac]

I too have heard of some trained athletes dying suddenly from heart problems too. I have also wondered about this too. Remember not long ago there was a women runner who died suddenly. And then not long later another. I have been told that when you work out that much and put that much strain on your body (heart) its not good for you. They develop cardiomyopathy. I also believe that they call it athletes ventricular tachycardia. There is a difference in working out and working out like they do. There have been Basketball players die from this as well football players, baseball players, and the list goes on. They  put so much strain on their hearts and I dont think its good for the heart. Sure a good cardio work out is good but not like they do it. Chris Penn the actor died a few years ago from cardiomyopathy he was over weight and they said his heart was three times the size it should of been.  I think a good brisk walk is better and healthly than running besides do you ever see a runner smiling. lol

[BHP39]

Arrhythmogenic right ventricular dysplasia  --- This is what Antonio Puerta died of.  I wonder if this is considered "structurally norma" or if this is a structural abnormality.  Anyone know?

[KLB32]

I don't have time to read through all the comments but those athletes likely had something like Long QT syndrome.  It has nothing to do with  benign PVC's.  My ex in college died from this disorder.  It is a hereditary condition (although sometimes acquired from certain medications).

What we also don't know is what drugs (if any) they were taking.  For all we know, they could have been drug users.  

I know it's scary to hear about things like this but try not to worry.  I agree with the Dr. that all the media hype just causes people to panic.

[wmac]

Arrhythmogenic right ventricular dysplasia, is not a normal heart. It is not good to have that....There is no cure for it either Was he Italian?? Because alot of Italian people get that and its very hereditary.