Hearts Can Be Tested, but Little Is Ensured
Dr. Milton J. Sands of New Britain General Hospital in Connecticut was understandably concerned.
When listening to basketball player Tony Penny’s heart with a stethoscope three years ago, he heard an unusual sound. The muscle contractions were abnormal.
Sands, a cardiologist, suspected the problem was a condition known as hypertrophic cardiomyopathy, or the abnormal thickening of the heart muscle.
But he could not be sure. He administered a more definitive test, a cardiac catheterization. A tube was inserted into an artery in Penny’s leg and directed to his heart. A dye was then injected into the heart chamber to help clarify X-rays.
The test confirmed Sands’ suspicions. Penny had a diseased heart.
Such testing is standard procedure when doctors examine patients they suspect have heart problems. But the tests ensure little.
Although Sands advised Penny, then 19, to discontinue his basketball career, Penny got other favorable opinions. He found three cardiologists who disagreed with Sands’ assessment. Then, after two years of sitting out, Penny returned to the court last season for Central Connecticut State, starting 15 games.
This season, he joined the Manchester Giants English professional team. But on Feb. 27, he collapsed after leaving a game and later was pronounced dead of sudden cardiac arrest at a Manchester hospital.
Whenever tragedy strikes a young athlete such as Penny or Loyola Marymount basketball star Hank Gathers, who died five days after Penny, the question most often asked is, “Why?”
Why did someone die with all those miracles of modern medicine?
But even the most sophisticated tests do not ensure detection of heart problems, cardiologists say. Still, there are standard procedures.
Once a patient shows symptoms of heart problems, physicians say they most likely will obtain a comprehensive history to determine whether he or she had a recent illness, an upper respiratory infection or exposure to toxins such as cocaine, amphetamine and alcohol.
After that, five nonevasive tests are administered. The most common are the electrocardiogram and chest X-rays, said Dr. Anil Bhandari of Los Angeles Cardiologist Associates at the Hospital of the Good Samaritan.
Another useful test is the echocardiogram, a high-frequency sound wave that is bounced off the heart and back. Using a computer, physicians can generate an image of the heart and its functioning process.
“It can tell us specially about two conditions: hypertrophic cardiomyopathy and Marfan’s disease,” Bhandari said. He said the test also indicates whether a heart has structural damage.
A fourth test is the Holter monitor, which registers cardiac rhythms for a 24-hour period. The test can establish presence of a condition called ventricular tachycardia, which is an abnormal heart rhythm. Gathers’ condition was diagnosed as exercise-induced ventricular tachycardia, according to Bruce Fagel, the Gathers family attorney and himself a physician.
Gathers, who fainted during a game Dec. 9, was treated for almost three months before he collapsed and then died on March 4 during a West Coast Conference tournament game at Gersten Pavilion in Westchester.
Gathers’ physicians have not discussed which tests he underwent. But Fagel, quoting medical records he obtained as part of an investigation for possible litigation, said Gathers was given many of the standard tests.
The fifth nonevasive test is the treadmill, which can unmask cardiac arrhythmia or chest pain, Bhandari said.
From these tests, physicians can determine their next steps, Bhandari said. If the tests are abnormal, so-called invasive tests are administered.
They are cardioelectrophysiologic stimulation, which indicates if there are electro abnormalities, and cardiac catheterization, the test Sands performed on Penny three years ago.
“That (catheterization) tells us about the heart as a mechanical pump,” Bhandari said.
GATHERS OFFICIAL CORONER’S REPORT The autopsy of Hank Gathers found that both ventricles were abnormally thickened. There was also inflammation and scarring of the heart muscle. The cause of death was officially listed as idiopathic cardiomyopathy with residdual interstitial myocarditis.
