Sudden death in Bentley player raises questions about EKG screening in athletes

The tragic sudden death of 19-year-old Joe Glynn, a Bentley University basketball player, who collapsed during a Monday night game raises the same questions that arise every time a young athlete dies far too early in life: Did he have an underlying health problem that contributed to his death? If so, could the problem have been detected earlier? Would that have saved his life?

Glynn had been playing a recreational summer league game in Watertown with many of his former teammates from the Middlesex Magic AAU club, and he never had previous health problems, according to one of his former coaches who spoke with me.

“He was healthy as a bull,” said Bill Boyle, co-director of the Middlesex Magic club in Belmont, “one of the healthiest kids I ever coached.”

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Glynn’s cause of death has not yet been determined, according to the Watertown police department, and an autopsy will likely be performed to see if he had a heart problem or a burst vessel due to an aneurysm.

Most sudden deaths in athletes on the playing field tend to be heart related. They can sometimes go into cardiac arrest if they are struck hard in the chest during play, but one of the players at Glynn’s game told a reporter that Glynn hadn’t been hit before he collapsed.

That begs the question of whether Glynn died from a genetic heart condition called hypertrophic cardiomyopathy.

“It’s an abnormal thickening of the heart and is the most common reason behind these sudden deaths,” said Dr. Mark Link, director of the Center for the Evaluation of Heart Disease in Athletes at Tufts Medical Center. The condition occurs in 1 in 5,000 people and often causes no symptoms, but it can usually be detected on a routine electrocardiogram (EKG) screening.

For this reason, some cardiologists have pushed for EKG testing in all high school and college athletes in an effort to prevent some of the 100 deaths per year that occur due to the condition.

But a 2012 cost-benefit analysis conducted by Boston researchers found that since deaths are so rare—occurring in 1 out of every 220,000 competitive athletes—screening all players before putting them on the field would result in an nearly inconsequential increase in the average player’s life expectancy with a signficant increase in medical costs for expensive followup medical tests and procedures.

Link called routine EKG screening an “unproven strategy” that has costs that extend far beyond those that are economic.

“It will prohibit many young people from playing sports unnecessarily,” he said.

That’s because most people with hypertrophic cardiomyopathy will never go on to experience sudden cardiac arrest.

“I have three children, ages 21, 19, and 14, all of whom play sports and none of whom had had an EKG,” he said.

While doctors often advise players diagnosed with the condition to avoid all strenuous physical activity, those recommendations aren’t based on evidence that will help extend their lives.

“There are all sorts of triggers” for cardiac arrest in these patients, Link said, “and it’s quite possible that diagnosing the condition early won’t go on to save their lives.” It’s a question, he added, that needs to be addressed in future research studies.

For now, Link would like to see more students learning cardiopulmonary resuscitation (CPR) in school health classes, so they’ll know how to aid an unconscious person with no pulse on or off the playing field.

He’d also like to see portable defibrillators at every sporting event. Several states have mandated defibrillators in public school gyms, but not Massachusetts.

Boyle said he frequently sees them hanging on the walls of basketball courts at local clubs, but he’s not sure whether one was nearby when Glynn collapsed at an undisclosed location in Watertown. It’s also not known whether any players on the court administered CPR to him.