Every few days, somewhere in the country, a young athlete drops dead from sudden cardiac arrest. Chris Phillips could have been one.
As a freshman defensive back for the Chattahoochee High School Cougars, he was running downfield during football practice when his hearing became muffled, his vision darkened, his back started to hurt and his breath became labored. He thought little of it.
The symptoms returned during a game. He kept playing.
But luck, or providence, was with Phillips. A teammate's father, whose company made echocardiogram machines, held a free heart screening for North Fulton athletes a few days later. When a physician examined the resulting sound-wave picture of Phillips' heart, he saw a life-threatening problem.
Phillips was 14 then. He's 29 now and married. His football career ended three games into high school, and he had to give up basketball and baseball, too. But he golfs and runs and works out at the gym. He takes a daily regimen of medicine, but he is usually unaware of the implantable defibrillator that sends electrical impulses to his heart.
"Fast-forward to today, and I pretty much lead a normal life," Phillips said.
That's what his cardiologist, Dr. Winston Gandy, wants for other young athletes at risk of sudden cardiac arrest. That's why Gandy spent time Thursday night in the Georgia Dome promoting heart screening for young athletes at the SEC men's basketball tournament.
Gandy is a leader in a broad national effort called "Close the Gap," which addresses disparities in cardiac care. African-Americans, Latinos and women are less likely to be diagnosed and treated for heart ailments --- and thus are more likely to die from them --- than white males like Phillips.
Heart disease causes one in three deaths in Georgia --- a rate 14 percent higher than the national average. African-Americans, who make up 28 percent of the state's population, account for 58 percent of deaths from cardiovascular disease, according to Dr. Christopher Leggett, an interventional cardiologist at St. Joseph's Hospital and a member of Close the Gap's steering committee
The heart-screening campaign aimed at athletes is sponsored by Boston Scientific's Cardiac Rhythm Management division and other organizations, including the Black Coaches and Administrators (BCA), the Atlanta-based Association of Black Cardiologists and the National Collegiate Athletic Association.
Young black athletes die disproportionately from sudden cardiac arrest, according to the American Heart Association. A possible explanation cited by the association in a position paper is that "socioeconomic status and biases within the healthcare system" limit many African-Americans' access to diagnostic testing.
About 110 young athletes die of sudden cardiac arrest every year, about one every three days, according to the Journal of Athletic Training.
"Nothing is more tragic than the loss of a young person with their whole life ahead of them," said Georgia Tech head men's basketball coach Paul Hewitt, president of the BCA. "The bottom line is that this campaign will save lives."
Gandy, an officer in the Association of Black Cardiologists, cites his patient Phillips as exhibit A for the effectiveness of screening. Though others disagree, Gandy said ideally every young athlete would at least have an EKG.
"When we screen these athletes and find out what put them at risk, we're often able to intervene in a whole family," said Gandy, who practices at Piedmont Hospital.
Phillips' problem turned out to be genetic hypertrophic cardiomyopathy, a thickening and stiffening of the heart walls that can be aggravated by heavy exertion. It's the most common cause of sudden death during exertion among adolescents.
After Phillips' diagnosis, about 15 relatives went for screening. Nine on his mother's side were found to have the condition. Seven, like Phillips, now have implantable defibrillators.
"My case kind of opened the door to exploring our family," said Phillips.
Some doctors argue that screening can't guarantee an athlete won't die of a heart problem and that even the best tests aren't always right.
The Georgia High School Association requires all would-be players complete a physical evaluation form that asks questions aimed at gauging risk for heart problems, a practice in sync with Close the Gap and American Heart Association recommendations.
Neither group argues that all athletes should receive echocardiograms or the less expensive electrocardiograms (EKGs), which measure the electrical activity of the heart. Both organizations suggest a screening questionnaire to assess personal and family history.
Widespread electronic screening of the country's approximately 10 million high school, college and community-based athletes is neither "prudent" nor "practical," the heart association said in a position paper last year.
The European Society of Cardiology and the International Olympic Committee reached a different conclusion.
"The strongest evidence" for requiring an EKG as part of a screening program "is the demonstration for substantial decrease in sudden deaths in screened individuals," wrote Italian physician Dr. Antonio Pelliccia, in an article in the European Heart Journal last year.
After three Georgia athletes died on the field during the 2002-2003 school year, some programs were established to offer inexpensive heart scans to young athletes.
One of them, Heart Screens for Teens, takes scanning machines to campuses to perform echocardiograms for $58 per student. In five years, the program has examined more than 5,000 students.
"Usually when a death happens, we have tons of parents contact us," said spokeswoman Stephanie Naus. "If a student hasn't died in about a year, we stop getting phone calls."
Phillips said he thinks all young athletes should be tested.
"As I've gotten older, my conviction has grown stronger that we're talking about a human life here," he said. "Athletes across the board need to be screened for this. It's not a restrictive thing in my mind. It's a protective thing."
SPECIAL RISK FACTORS
The American Heart Association advocates a questionnaire to see which young athletes are most likely to have a cardiovascular problem. Any young person who meets any of the following criteria should have further cardiovascular examination, according to the association:
> unexplained fainting or light-headedness
> unexplained excessive fatigue
> heart murmur
> high blood pressure
> one or more relatives who died of heart disease before age 50
> close relative under 50 with disabling heart disease
> cardiac conditions running in the family
Copyright 2008 The Atlanta Journal-Constitution