Monday, September 20, 2010

A busy weekend in sports and cardiology

2 items from the weekend caught my attention:
1) A high school football player in Oregon had sudden cardiac arrest. He was saved by a cardiac nurse who was in the stands, saw him collapse and, presumably, did CPR. He was diagnosed with an anomalous coronary artery and had successful heart surgery.
Anomalous origin of a coronary artery is a condition one is born with. It is a leading cause of cardiac arrest (approximately 20% of cases). There are many different coronary anomalies. The ones associated with cardiac arrest involve either the left anterior descending coronary or the right coronary arising from the opposite coronary cusp from normal. The artery then courses in between the aorta and the main pulmonary artery. Cardiac arrest can occur when the artery is compressed, causing ischemia (lack of blood flow) and either a heart attack or an irregular rhythm. Fortunately, the football player survived and had corrective surgery.
http://www.kgw.com/news/local/HS-football-player-prepares-for-heart-surgery-103283964.html
2) Michigan State's football coach, Mark Dantonio, suffered a heart attack hours after making an incredible call, faking a field goal, in overtime, to score a touchdown and win a big game against Notre Dame. Several hours after the game, the coach had chest pain and went to the hospital. He was taken to the cath lab, found to have blockage and a stent was placed.
We have known for years that stress can precipitate heart problems, including a heart attack or sudden cardiac arrest.  Stress will trigger a "fight or flight" response in the body, releasing adrenaline and cortisol. These hormones will increase the heart rate, increase blood pressure and make the body more prone to blood clotting. These responses may have been helpful in the jungle when we need to fight an enemy or a wild animal. but they are detrimental if someone has underlying heart disease. The hormones may constrict  a blocked heart artery, the increased heart rate and blood pressure increase the heart's demand for oxygen, which may not be met by a blocked artery and the propensity to clot can lead to a blood clot within a blocked heart artery. All of this may lead to a heart attack, followed by sudden cardiac arrest.
http://sports.espn.go.com/ncf/news/story?id=5592217 
Fortunately both cases turned out OK.