Aurora teens' death prompts concerns about heart testing

Playing basketball shouldn't be a deadly endeavor. Neither should drill team practice, or kickball.

But it was for Zamarri Doby, the Waubonsie Valley High School student who collapsed and died Sunday, four minutes into a basketball game at Plainfield South High School. And it was for 18-year-old St. Charles North High School senior Lauren Laman, who earlier this year collapsed during drill team practice and died of mitral valve prolapse. And it was for 12-year-old Wesley Zamost, a Mundelein resident who suffered an aortic dissection during a kickball game in 2007.

Like the others, 16-year-old Doby succumbed to a previously undetected cardiac condition -- in this case an enlarged heart also known as hypertrophic cardiomyopathy, or HCM.

An especially insidious disease with few obvious symptoms, HCM causes about one-third of all sudden cardiac deaths, says Dr. Joseph Marek, a clinical cardiologist and the medical director for Young Hearts for Life. Young Hearts is a free cardiac screening program sponsored by the Midwest Heart Foundation, a research and education agency located in Lombard targeted at high school students.

More Coverage Links Zamarri Doby loved to make people smile [06/24/08] Services, benefit fund set for Aurora teen who died during game [06/24/08] Athlete collapses on court, dies at 16 [06/23/08]

According to Marek, another 20 percent of sudden cardiac deaths result from congenital coronary anomaly, a rarely detected condition where an abnormal configuration of the arteries restricts blood flow during times of intense physical activity. Less common causes of death include a ruptured aortic aneurysm, myocarditis and the aforementioned aortic dissection, in which the heart's main artery bursts.

When it comes to these silent killers, electrocardiograms that measure the heart's electrical activity and echocardiograms that use ultrasound to produce an image of the heart offer the best means of detection.

"The EKG (electrocardiogram) is a great screening test," says Marek. "It can detect approximately 90 percent of HCM.

"The definitive test is the Echo (echocardiogram), which is more specific and more certain," he says.

But the EKG, which can be administered by parent volunteers, is the most cost-effective way to screen for undetected problems in youngsters, Marek says. In Italy, which screened all competitive athletes between the ages of 12 and 35 from 1979 to 2004, the annual rate of sudden death in that population dropped by 89 percent over that 25-year period.

In the United States, doctors don't perform such tests on seemingly healthy young people like Doby or 20-year-old, "enviably fit" Max Schewitz of Lake Bluff, who died in 2005 of sudden cardiac arrhythmia.

Cost plays a factor. The price of equipment ranges from $3,000 to $10,000 for an EKG and up to $250,000 for an Echo. An EKG can run a patient between $10 and $35, while an Echo can cost up to $600. That's where Marek's Midwest Heart Foundation and its partner -- The Max Schewitz Foundation, founded by his parents Mary Beth and David -- comes in.

The Midwest Heart Foundation began offering free EKGs to DuPage County high school students in 2006. Since then, it has screened 19,000 people, of which 2 percent showed abnormalities requiring additional testing.

The Schewitz Foundation, in cooperation with the Midwest foundation, screened 2,000 kids at Libertyville and Lake Forest High schools last fall. Twenty-five tests came back abnormal, with two of them indicating life-threatening conditions. In the case of one student, a sibling shared the condition.

"That's three lives that we know of that we altered," says foundation director Mary Beth Schewitz.

"It's like searching for a needle in a haystack," says Marek. "But they're not needles; they're our kids."

Doby's death again has raised the issue of screening young athletes for these potentially life-threatening conditions.

"I'd love to see schools mandate (testing) as a condition to participating in sports," says Schewitz, adding that consumer demand could make such tests standard, like mammograms, prostate exams and screenings for cervical cancer.

To that end, Naperville Unit District 203 leads the charge. Several years ago, the Midwest Heart Foundation began EKG screenings of Naperville North and Naperville Central high school students who had their parents' permission. Beginning this fall, all students, not just athletes, will have been screened, Superintendent Alan Leis says.

Not every district has adopted such a comprehensive approach. Most, including Northwest Suburban High School District 214, the state's second-largest high school district with 13,000 students, relies on mandatory physicals and the completion of the IHSA pre-participation examination form listing medical history.

It's a start. But for some kids, it's not enough.

"Many experts in the field suggest that any student participating in athletics should have an EKG," says Dr. Parag Doshi, a cardiologist at Alexian Brothers Medical Center in Elk Grove Village and head of interventional cardiology at St. Alexius Medical Center in Hoffman Estates.

An EKG that shows abnormalities should be followed by the more thorough Echo, he says. But the first step is a basic checkup that includes a thorough family history and questions the student about chest pain, dizziness, breathing problems or fainting he or she might have experienced.

"Parents need to be mindful if their child experiences these symptoms and not discount them," Marek says. "Upward of 50 percent of victims may have had symptoms. My kids have all had the symptoms, but it's usually when the garbage needs to be taken out."

The sad truth is that once a catastrophic cardiac event begins, there may be little anyone can do to reverse it. Unfortunately, CPR does not work in those cases, Doshi says. But an automatic external defibrillator, which some schools, airports and public facilities have installed, might.

"Every second counts," says Doshi. An AED, which recognizes the fatal cardiac rhythm known as ventricular fibrillation and corrects it, can be used by a lay person to save someone's life.

"It can mean the difference between life and death."