In November 2007, Ryan Shay collapsed after only 5 1/2 miles of the US Olympic marathon trials. In July 2012, former Stanford University basketball player Pete Sauer collapsed while playing a friendly game in his adult recreational league. In October 2012, the BYU swim team went up against the University of Hawaii when Hawaii swimmer 'Peter' Frank Chi was found unresponsive in his dorm room post-meet. Chi was a rare case who knew about his heart condition and took precautions but still died as a result of his heart condition.
Olympic runner Ryan Shay died of a cardiac disturbance because of hypertrophic cardiomyopathy.
Each of these young adults suffered from sudden cardiac disturbances which led to their death. The fact that such young, athletic healthy people can suddenly fall to their death without warning is becoming a greater concern and higher frequency among athletes today.
'(The most common) is an enlarged heart, called hypertrophic cardiomyopathy,' clinical nursing supervisor and USA Track and Field Coach Maureen Bartley said, 'which is an abnormal thickening of the heart wall that can lead to rhythm disturbances.'
An enlarged heart is hard to recognize since it is an organ that's hidden from view and shows no outward symptoms.
'Hypertrophic cardiomyopathy comes from genetics,' BYU Professor J. Ty Hopkins, of the exercise science department, said. 'Most people that get it have a predisposition to this abnormality.'
The best test to discover this kind of heart problem is an echocardiogram, but a test like that can cost anywhere from $800 to $1,400.
'An echocardiogram shows the make up and the size of each individual chamber within the heart,' Hopkins said.
A question is whether high schools and colleges address this issue, and whether they should be required to worry about it or leave discovery responsibilities to the athletes.
'We do physicals on our athletes every year,' director of BYU sports medicine Carolyn Bilings said. 'Basically, we check blood pressure and listen to their heart sounds.'
While this alone may not detect many of the heart issues that can result in an athlete's sudden death, it's a start to finding anything that may lead them to consult a physician.
Because an echocardiogram is not a plausible way of testing the over 250 athletes at BYU, the sports medicine department has had to come up with other ways of keeping their athletes safe.
'The athletic trainer monitors them,' Bilings said. 'So as soon as we notice that there are problems or concerns — if they have complaints of being dizzy, not feeling well, their blood pressure has changed or they are passing out — we would get them to the doctor.'
The majority of athletes who have died from sudden cardiac arrest have been fairly young, generally in their 20s and 30s.
'(With hypertrophic cardiomyopathy) you don't exhibit symptoms,' Bartley said. 'The heart condition can be totally independent of how you look on the outside. You can be a very fit individual, and there's no telling if and when it could become a problem.'
Hypertrophic cardiomyopathy is an underlying condition that can be brought to the surface through certain habits and activities the person chooses to do. A person may not know they have this heart condition until it is too late.
Runners are the most common athlete to suffer from hypertrophic cardiomyopathy
'Because athletes exert themselves to maximum effort, pushing hard, pushing beyond normal to that red line, doctors feel like that may contribute to the problem because they do it so often,' Bartley said. 'It's an underlying condition that people don't know they have, and their athletic efforts actually then bring it to the surface.'
The only real knowledge on preventive care as far as these heart conditions go are to check family history records.
'It tends to be genetic,' Hopkins said. 'People have a predisposition to this abnormality. People that are at higher risk are those that have a condition called marfans; they're taller, lanky and have long fingers.'
If an echocardiogram is too expensive and there are no other outward signs or symptoms of having this heart defect the question remains for athletes on how to detect it.
'The only thing I can think of is that this is a hereditary condition most of the time,' Bartley said. 'So if (athletes) have a family history of heart disease or death from heart problems at a young age, they should probably consider getting tests done and pay attention to how they feel.'
Being alert to the body's responses to physical exertion is key to preventing health problems and is becoming more and more required of athletes of a younger age. This general concern has hit home at the college level but has not been as prevalent for high school athletes yet.
'That hasn't been something, thankfully, that we've run into,' Timpview Highschool Athletic Director Al Poland said. 'The big thing right now in terms of injuries in kids is concussions.'
As far as the college athlete is concerned, Bilings suggested athletes do as much as they can to be aware of what's going on in their body.
'Be diligent about when you don't feel well and to not just assume it's going to go away,' Bilings said.
Even when athletes do know, as in the case of Chi, and practice diligence in staying as healthy as possible, the risk of death does not disappear.