THE DEATH OF HANK GATHERS : Cummings’ Case Isn’t the Same : Heart conditions: NBA player has an irregular heartbeat, but his doctor says the similarities to Gathers’ case end there.

On Dec. 13, 1982, Terry Cummings, in the middle of his rookie season with the then-San Diego Clippers, fainted on the court during a game in Salt Lake City. Doctors who examined Cummings would later determine that the 6-foot-9, 235-pound forward suffered from a cardiac arrhythmia--an irregular heartbeat. But at first, they were baffled.

“All the usual studies kept coming up with negative assessments,” said Dr. Richard Kehoe, a Chicago cardiologist who treats Cummings. “Only when Dr. H.C. Palmer, then the Clippers’ team physician, went to extreme lengths to sort things out did (physicians) find out what was wrong. They put a heart monitor on Terry during a game, and he had a mild (fainting) episode. Then they found out that Terry had an arrhythmia.”

Cummings, currently playing for the San Antonio Spurs, has a condition known as ventricular tachycardia, which causes a rapid beat in the lower chamber of his heart. While keeping his condition under control with medication, Cummings, who turns 29 next week, has built a solid NBA career, twice playing in the NBA All-Star game. In fact, he has missed only 12 games since going on the heart medication seven years ago, and he has missed those games for reasons unrelated to his heart condition.

The death of Loyola Marymount star Hank Gathers on the court last Sunday during a West Coast Conference tournament game has refocused attention on Cummings, who has said he cried when he learned of Gathers’ death. “I saw Terry in Hank,” Cummings said.

Gathers also suffered from a cardiac arrhythmia. But Kehoe, who has treated Cummings since 1983, said Wednesday he sees only superficial similarities between the two.

They are both talented basketball players who suffered fainting spells on the court, he said. “And there the analogy begins to break down. They probably have very different arrhythmias and problems with their hearts.”

Gathers fainted during a game on Dec. 9 and underwent a battery of tests before returning to the Lions’ lineup on Dec. 30. An arrhythmia was noted, and Gathers began taking a drug, Inderal, that is sometimes prescribed for an irregular heartbeat. However, Gathers reportedly had reduced his dosage of the medication or stopped taking it altogether--a fact that Kehoe believes could have contributed to Gathers’ death.

“If Hank had cut his dosage back or stopped (taking the drug), it could have made (his condition) worse,” Kehoe said. “Patient compliance is an extremely important element in successful therapy of a problem. Terry realizes that his playing in the NBA is a function of this (irregular heartbeat) not coming back, even in the form of an odd dizzy episode. He’s doing everything he can to be a good patient. Fortunately, the medication he’s on is one that allows him to keep his physical stamina (as opposed to the way Inderal affected Gathers).”

Since his heart problem was diagnosed in 1983, Cummings has been taking Amiodarone to control it.

He has said that the medication affected his sense of balance at first. “I was walking around high, but nobody knew it,” Cummings said.

Kehoe said the dosage was adjusted in such a way that Cummings could take the drug and not suffer any side effects, adding: “Terry was very mature and very compliant with a rigorous cardiovascular evaluation.

“When he did have side effects, we all got together and conferred. We readjusted the dosage. That allowed him to be treated effectively, but with a minimal awareness of the drug.”

After the condition was diagnosed, Kehoe said, Cummings was monitored during “numerous games” with the same device that had detected his second dizzy spell. The monitoring lasted throughout the 1983-84 season, Cummings’ last with the Clippers. At the same time, the Clippers kept a defibrillator--a machine used by paramedics to shock a failing heart back to a normal rhythm--on their bench because of the club’s worries about Cummings.

“That first training camp, it was like we watched his every breath,” said Don Chaney, then a Clipper assistant coach and now head coach of the Houston Rockets.

Kehoe said doctors felt it would have been “unnecessarily conservative” to prohibit Cummings from playing basketball, because, he said, their testing showed only a 5% chance of Cummings fainting again.

“I think each patient, whether it’s an athlete or not, has to be evaluated on an individual basis,” Kehoe said. “Restrictions on life style have to be determined by what the probability of effective control (of the problem) is. If effective control is in the 90th percentile, then it’s hard to quibble with letting an individual resume, in a monitored manner, normal activity and, if all goes well, letting that individual go back to the level (of activity) he had before.”

While Kehoe acknowledged that he has told Cummings, “If you faint again, there’s a risk that the episode could be lethal,” the cardiologist said such a risk isn’t enough to force Cummings to retire from the NBA.

“Certainly, some people might say that a 5 or 10% risk is too high,” Kehoe said. “But it depends on the individual’s feelings. Unfortunately, Gather’s next manifestation of fainting was a fatal one. Usually people will manifest arrhythmia as they did in the past (with a fainting spell). Were that to have happened to Gathers a second time, it would have been a telltale sign that ‘this treatment is not working--better back off.’ ”

But that didn’t happen to Gathers--another sign, Kehoe said, of the difficulty of detecting and managing heart problems in athletes.

“Unfortunately, as is obviously the case with Gathers, you could play 12 or 15 games and not have another spell occur,” he said. “It’s like trying to find a rattle in a car.”