Jordan Boyd is shown in a 2013 training camp portrait released by the QMJHL on Monday Aug. 12, 2013. The 16-year-old died Monday in Bathurst, N.B. after he collapsed during tryouts.
The need for reliable screening for heart conditions that can lead to sudden death has been highlighted after 16-year-old Jordan Boyd died earlier this week after collapsing during a tryout with a Quebec Major Junior Hockey League team in New Brunswick.
While Boyd's autopsy results had not been released as of Wednesday afternoon, experts say undetected heart conditions are the most common cause of sudden death among seemingly healthy young people.
"Hypertrophic cardiomyopathy (HCM) certainly is one of the more common causes of sudden death in young individuals but other conditions exist, such as those that affect purely the electrical system of the heart," said Dr. Michael Gollob, director of the Inherited Arrhythmia Clinic and Arrhythmia Research Laboratory at the University of Ottawa Heart Institute.
HCM affects approximately one in 500 individuals. Athletes typically draw the most attention because they represent the healthiest of the population and are active, which can trigger arrhythmias – abnormal heart rhythms – that can cause sudden death.
But Gollob said children with the condition doing any sort of activity could prompt a tragic outcome as well. "What draws little attention though is the little girl who died during recess," Gollob said.
There is no mandated screening system for athletes except in Italy.
In Canada, it's left to the discretion of individual provinces and teams to decide how and when screening occurs.
The NHL, for example, screens only its top 100 draft choices. Cost is the main issue.
"Is it worth spending millions of dollars to screen athletes of whom the vast majority are
perfectly healthy and do not have these conditions?" Gollob said.
While universal screening may not be practical, Gollob suggests an individual's family history should be reviewed.
Has anyone in their family died suddenly and inexplicably before the age of 40? Is there a family history of epilepsy? A yes to either of these questions is a red flag.
A more thorough (and expensive) test is ECG analysis, which measures the heart's electrical activity.
However, Gollob said false positives are common, as an ECG is like a fingerprint, and normal variations may look abnormal to a physician.
"It could lead to excluding an individual from a very healthy lifestyle," Gollob said.
Heart conditions can remain "clinically silent" where individuals may show no symptoms and are unaware there's anything wrong until something serious happens.
"Some individuals can carry the bad gene for HCM and only have mild disease well into adulthood. Other individuals can carry the bad gene for HCM and have very severe disease in childhood," Gollob said.
If an individual has ever experienced shortness of breath, chest pain or has fainted while being physically active, it is important they see a doctor to make sure they don't have one of these conditions.
"The impact of these tragedies is immense, on the families, friends and community at large," Gollob said.
"Young athletes are believed to represent the epitomy of health, and their sudden demise is a challenge to understand."