Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: MONDAY, March 11, 1991                   TAG: 9103090394
SECTION: EXTRA                    PAGE: E-6   EDITION: METRO 
SOURCE: JANE E. BRODY
DATELINE:                                 LENGTH: Medium

MAJORITY OF CARDIAC DEATHS IN ATHLETES CAN BE PREVENTED

A year ago it was Hank Gathers, the basketball star at Loyola Marymount in Los Angeles who collapsed and died in a conference championship game.

Ten days ago a 15-year-old Bronx high school girl, Stephanie Companion, collapsed and later died after running in a track and field championship race. And last Sunday, a Yale sophomore from Ainsworth, Neb., Bryent Wilkins, 19, died suddenly while playing intramural basketball.

Why do such tragic things happen to people in the flush of youth who are doing what all people are urged to do: exercise?

All three were known to have had a heart problem. Although Companion's heart murmur was not considered significant, Gathers and Wilkins had enlarged hearts that could result in serious rhythm disturbances during exercise.

Gathers, who was on medication, was permitted to play even though he had cut his drug dose in half.

The Yale Daily News, the campus newspaper, reported that Wilkins had been told not to participate in vigorous sports but did so anyway.

Beyond the entrance physical required of all students, medical clearance is not required at Yale for intramural athletics.

In most cases of such deaths, though, the young athlete is believed to have been perfectly fit. Sometimes no checkup is done before sports participation. More often, a cursory examination fails to uncover a problem that might rule out vigorous activity and competition.

Despite the attention they receive, such deaths are rare. In the current American Journal of Diseases of Children, pediatric cardiologists say the annual incidence is estimated to be one or two cases for each 200,000 athletes 30 years old and younger.

The team, headed by Dr. Francis M. McCaffrey of the Medical College of Georgia, said data indicated approximately 5 in every 100,000 young athletes have cardiovascular conditions that make them vulnerable to sudden death. Of those, about 1 in 10 will suddenly and unexpectedly die.

Dr. Steven P. Van Camp, a San Diego cardiologist, said that judging from newspaper reports, about 10 to 25 sudden deaths occur each year among the millions of young athletes.

Nonetheless, except for traumatic injuries, cardiac death is the most frequent cause of sports-related deaths among young athletes.

In an interview, McCaffrey emphasized that it would be far too expensive to give all children the thorough examinations to identify the few at risk.

But, he said, the majority of such deaths can be prevented. Most important, he and others insist, is a medical screening: a personal and family medical history and ordinary physical examination, with further testing if something unusual or suspicious turns up.

Many abnormalities can be corrected or treated. In other cases, restricted activity may be recommended.

But McCaffrey and Van Camp agree that it is up to the youths, their parents and coaches to decide on the level of activity, based on full information about the risks.