Cuttino Mobley has a Big Heart
February 09, 2009
In November 2008, Cuttino Mobley was a star point guard in the NBA. In December, he chose to end his NBA career to avoid possible sudden cardiac death due to hypertrophic cardiomyopathy (HCM).
Remember the sudden death of college basketball player Hank Gathers? Why don’t all athletes undergo screening for HCM? The answer is: screening tests don’t always work as well as people think.
A good screening test is inexpensive and sensitive. Sensitivity refers to the test’s capacity to detect the disease. Many athletes are first screened for HCM using an electrocardiogram (ECG). While the ECG is an inexpensive test for HCM, it only detects 80% of patients with HCM at best (80% sensitive), with some criteria detecting only 36% of patients with HCM (36% sensitive). This means that a good 20-64% or more of patients with HCM will have an unremarkable ECG. ECGs are also not very specific for HCM; there will be many patients who screen positive for HCM who turn out to have something that is not dangerous at all, such as Athlete’s Heart.
Patients who do screen positive or who have a history of a family member dying suddenly, or a personal history of passing out (syncope), may be directed by their doctor to get further testing with an ultrasound, CT, or MRI – but even those tests are not perfect. To manage the risk of sudden cardiac death for the athletes who have slipped through the screening process, many schools and arenas supply Automatic External Defibrillators.
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