Do They Have the Heart to Play?

When Kevin Sok, a forward on his Santa Ana high school’s junior varsity basketball team, had his routine preseason physical, a doctor found an irregular heartbeat -- a potentially fatal abnormality that put the 16-year-old on the bench.

Sok needed an expensive ultrasound examination, but his parents lacked health insurance.

“I was thinking that I wasn’t going to be able to play basketball again,” said the Century High School junior. “It’s my favorite sport.”

But a volunteer group stepped in to provide an echocardiogram, which showed that Sok’s heart was healthy. Under a new program, the Kevin Armstrong, M.D. Memorial Sports Foundation is screening all Santa Ana football players for congenital heart defects and agreed to screen Sok because of his doctor’s concerns. Next year, the program will be expanded to all district athletes.

“It’s all about prevention,” said Al Mijares, superintendent of the Santa Ana Unified School District. “This is allowing students to be checked physically to make sure they have the health necessary to withstand the grueling athletic events they’re involved in.”

In recent years, reports of heart defects suddenly killing high school and collegiate athletes -- including a Fountain Valley High School football player in 1999 -- have led to calls for increased health screening.

The California Interscholastic Federation, which oversees high school sports, requires prep athletes to receive a preseason physical. But these physicals often overlook congenital heart defects, and few students are tested further.

Nationally, volunteer organizations have begun providing echocardiograms, which can cost several hundred dollars, but these efforts touch only a fraction of the nation’s 7 million athletes.

“It’s completely inadequate,” said Holly Morrell, executive director of A Heart for Sports, a Yorba Linda-based nonprofit organization that has screened more than 5,000 student athletes for heart irregularities. “The athletes you hear about dropping dead on the playing fields are dying in vain. Their lives can be spared.”

A high school athlete has about a one in 200,000 chance of dying from a heart problem during practice or competition, according to the American Heart Assn.

Santa Ana school officials say their testing program is especially important because it serves athletes in a low-income community where many people lack health insurance. That was a critical concern of the foundation’s namesake, a former Santa Ana student who worked as a sideline physician during local high school football games. Armstrong died this year from heart disease. The foundation provides screenings using volunteer physicians and echocardiogram equipment donated by medical firms.

So far, 200 football players have been screened, including one diagnosed as having an enlarged heart, a condition that often presents no symptoms.

“Most of these kids will not have an opportunity to see a doctor, let alone have an echocardiogram,” said Mel Tonkon, a Santa Ana cardiologist who is on the board of the Armstrong foundation.

“We’re very excited about giving back to the community.”

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Snapshot of a heart

Athletes in Santa Ana are being screened for potentially fatal congenital heart defects. Doctors use an echocardiogram, which takes an ultrasound image of the heart and can reveal defects that often go undetected by a routine physical. Among the ailments that can be detected is hypertrophic cardiomyopathy.

How a normal heart works

Blood flows from the right side of the heart to the lungs, back to the left side of the heart, then to the body. The heart’s walls are made of muscle known as the myocardium.

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Hypertrophic cardiomyopathy*

With cardiomyopathy, some of the myocardium is thickened and can obstruct the flow of blood out of the heart. The abnormal tissue also can affect heartbeat.

*There are different types of hypertrophic cardiomyopathy. An asymmetric septal hypertrophy with obstuction is shown above.

Source: The Cardiomyopathy Assn.