The best physicians are the ones who learn not only to cheat the rules of death, but also how to do it preventively.
Theodore Abraham, an associate professor of medicine at Johns Hopkins University, as well as one of the nation's leading cardiologists, has seen more than a few young men and women die from hypertrophic cardiomyopathy, enough to wonder what he could do to help more of them get the better of death, or at least forestall it for a while.
"We're at Hopkins," Abraham said. "We have a lot of expertise and, yes, we can see patients and we can do everything after the fact. But it just kept burning a hole in me."
As a result, Abraham enlisted the help of more than 70 volunteers, as well as the assistance of General Electric and the Maryland Public Secondary Schools Athletic Association, to launch the "Hopkins Heart Hype" campaign to raise awareness about HCM, which kills more people younger than 30 suddenly than any other cause.
The first part of that campaign comes tomorrow, during the state track and field championships at Morgan State University.
While the running and field events are taking place at Hughes Stadium, doctors and volunteers will conduct screenings at nearby Hurt Gymnasium, including administering echocardiograms, at no cost to the participant.
Those tests could go a long way toward spotting evidence of HCM, which is usually undetectable in a regular physical examination, yet could be present in one in every 500 to 750 people in the general population, Abraham said.
Hypertrophic cardiomyopathy occurs where the heart muscle is unusually thick. In some cases, Abraham said, the HCM can act as boxes around a door that make the passage of blood difficult. In other cases, blood might be able to flow out, but the heart might not be able to relax or an abnormal rhythm might occur.
HCM is a genetic disease that is passed from parent to child and whose symptoms can be masked, Abraham said. The disease is admittedly rare, but perhaps not as rare as commonly thought.
"I ask [a deceased person's survivor], `Were they doing fine the day before?'" Abraham said. "They'll say yes, because it's not like these folks go into the hospital and have a slow death. It's a sure hit."
The disease catches seemingly healthy young athletes, such as Megan McColgan, unaware. McColgan, then known as Megan Finn, was a field hockey player at Overlea who collapsed on the field during a routine Saturday morning practice in 2004.
McColgan was administered cardiopulmonary resuscitation by Jenna Zava, her quick-thinking coach, and eventually rushed to University of Maryland Medical Center, where she stayed on a ventilator for three weeks and remained in the hospital for two more weeks.
Like many athletes who have survived a bout with HCM, McColgan said she had no idea she had the ailment, as she had passed a routine physical before competing. She said she had attributed her sluggishness and being out of breath at the time to attempting to get back into shape after a few years of inactivity.
McColgan, 19, who lives with her husband in Virginia Beach, Va., had a defibrillator inserted into her chest after the attack, and is on a daily regimen of metoprolol, a beta blocker, and aspirin. The medications, she said, can slow her down, and there are concerns over whether she could carry a baby given the increase in fluids in the body during pregnancy.
"It would have been better if they had caught it before for all of us," said McColgan, who added that she doesn't blame any of her doctors for what happened. "I went from being so active and doing dance and all kinds of sports to not doing anything at all. That was the hardest thing for me, that I couldn't be myself."
But, as Abraham points out, having HCM does not have to make one a couch potato. Given the proper medication, an HCM sufferer can jog or swim or engage in some forms of exercise in moderation.
The best way to detect HCM is with an echocardiogram or EKG, Abraham said. An EKG, which records the electrical activity of the heart over a period of time, could indicate the first sign of trouble in an otherwise seemingly healthy heart.
The problem is that while the Maryland Public Secondary Schools Athletic Association requires all athletes to have a physical, most physicals do not include EKGs. Also, EKGs are expensive, ranging, on the high end, from $700 to $1,000 each, Abraham said, making them out of the question for the families of many athletes.
Luckily, GE has agreed to ship 15 portable cardiovascular ultrasound units, as well as nine EKG machines, a loan of equipment that exceeds $1 million.
The screenings are an outgrowth of a conversation Abraham had last summer with Nancy Grasmick, the state superintendent of schools, about a potential partnership on this issue. Grasmick and Ned Sparks, the MPSSAA's executive director, agreed that the track championships provided the best opportunity to reach out to the most athletes.
Sparks said MPSSAA officials will remind people on site during today's preliminaries about tomorrow's event. Pre-registration is not necessary and permission forms can be downloaded at mpssaa.org.
However, Sparks said he worries that many kids will either forget to either bring the completed form or to have their parents present today to give consent on the site.
While officials are hoping to see up to 1,000 kids tomorrow, they say they'll be happy to get half that many, and Abraham said this is just the first step in a process that will help him and others stay a step ahead of death.