BODY : FITNESS & EXERCISE SILENT HEART DISEASE MAY NOT BE SO SILENT AFTER ALL.

Byline: Jason Kahn Medical Tribune News Service

For years, it has been thought that there is no way to predict which seemingly healthy young athletes will suddenly collapse from heart problems during a game and die.

But in a new finding that should allay fears of doctors and the public alike, Italian researchers report that in many instances, sudden death among athletes is not so unexpected after all.

Silent heart disease among young athletes may not be as silent as previously believed, said Dr. Domenico Corrado of the University of Padua in Italy. ``The good news is that many of the warning signs can be detected and treated,'' Corrado reported at the annual meeting of the American College of Cardiology.

In a study that looked at the cause of death in 46 competitive athletes under age 35, sudden death was frequently preceded by warning symptoms or changes on an electrocardiogram (ECG), Corrado reported. Electrocardiograms are electrical tracings of the heart's activity that can pick up abnormal rhythms or disturbances.

In his study, Corrado found that 10 of the athletes who experienced exercise-related sudden death suffered from an abnormally thin upper right heart chamber, which may have been picked up by an ECG. In addition, nine of the athletes had clogged heart arteries and seven had congenital abnormalities in their heart arteries.

Such cases can and should be caught while athletes are young, preferably in high school, according to Dr. Adolph Hutter, a cardiologist for the New England Patriots football team and the Boston Bruins hockey team.

``Taking a good patient history and performing a physical exam including an ECG should pick up the vast majority of the phenomena that could lead to sudden death,'' said Hutter, also of Massachusetts General Hospital in Boston. Then, any athletes who may be predisposed to fatal heart problems can be weeded out, he said.

Hutter said important questions to ask young athletes are: 1) Do you have chest pain or dizzy spells after exercise? 2) Have you ever passed out after exercise?

In addition to taking an ECG reading, doctors should look for abnormal blood-pressure measurements and listen for heart murmurs, he said.

Hutter stressed that the majority of young athletes in the United States are being assessed this way, and that such measures are responsible for the very low overall incidence of sports-related sudden death in this country.

Nevertheless, there always will be two or three well-known sports stars struck down each year by heart abnormalities during or just after a game, he said.