Heart Failure in Youth Likely Is Congenital

Massive coronary arrest like the one that killed an 11th-grader on the basketball court in Irvine on Wednesday is extremely rare and usually triggered by some congenital heart defect, according to a heart specialist at UCI Medical Center in Orange.

Dr. Byron Allen, UCI’s director of coronary care, said that in the “vast majority of cases,” adolescents who suddenly die during exertion “have some congenital heart disease that has not been diagnosed.”

Allen said the most common culprit is a genetic disease called hypertrophic cardiomyopathy which causes an abnormal thickening of the heart muscle that predisposes its victims to abnormal heart rhythms.

This disease “usually manifests itself in the teens or 20s” during strenuous activity, he added.

But Allen said sometimes a person can live a normal life span with the disease or not suffer a heart arrest until an older age.

For instance, he said, one of his patients is a 35-year-old woman whose congenital heart defect made her collapse two weeks ago on a tennis court. In that case, he said, a doctor who was playing in the next court and paramedics were able to revive her.

Yet another possible explanation, Allen said, would be a viral infection.

“There are cold viruses that in the vast majority of people cause just a cold,” he said, “but for some whose immune systems are undermined they can attack the heart.”

Allen said sudden death in adolescents is so rare that it is not practical to screen everyone in that age group for heart disease. But he said that children whose parents or siblings have congenital heart disease should receive electrocardiograms to look for heart rhythm abnormalities.