When it was revealed eight days ago that two Pitt football players, freshmen Zack Gilbert and George Hill, would be forced to sit out after being diagnosed with heart conditions, the news was met with an outpouring of disappointment, grief and empathy for two athletes whose respective careers were suddenly in jeopardy or, worse, over before they even could begin.
With that agony, however, came an undercurrent of relief. As awful as this is, the sentiment went, thankfully it was discovered before it was too late, that it was identified through a series of tests instead of an autopsy.
Had either player attended a different school, their ailments might have remained undetected. Pitt requires all of its incoming athletes to receive electrocardiograms (EKGs) and echocardiograms, tests that evaluate a person’s heart and attempt to uncover any abnormalities.
Pitt’s use of those tests puts it at the center of an ongoing discussion over whether such measures should be pervasive and uniform across college athletics. Rare as such heart conditions might be, Pitt has two living examples in Gilbert and Hill who show how effective and important its mandatory medical protocol is.
“What are the chances of finding something? If it were my kid, I wouldn’t want them playing roulette,” said Rob Blanc, Pitt’s head athletic trainer. “But when you look at the real numbers, what are you really looking for? It’s that needle in a haystack.”
The EKGs, which check the electrical activity of the heart, and echocardiograms, which are sonograms of the heart, are done in addition to a newly arrived athlete’s standard physical that must be completed before beginning competition. If the cardiologists spot an irregularity on a reading, they’ll administer follow-up tests, which often include cardiac MRIs and a stress test in which the athlete walks briskly on a treadmill while attached to monitoring equipment.
If a risk is identified, doctors will try to see if it is modifiable through medication or other interventions. If not, as it was with Hill, they recommend a life-long restriction from competitive sports. Gilbert will miss this season, and his opportunity for future participation will be reevaluated after the season.
Pitt has had all of its athletes undergo these tests for the past 12 years. Before this year, only four or five, according to Blanc, had required some kind of additional testing, all of whom were cleared. To have two players on one team in a single class both be diagnosed with such conditions is, as he put it, “very rare.”
Dr. Timothy Wong, a cardiologist from the UPMC Heart and Vascular Institute, said fewer than 2 percent of college athletes have any potentially career-ending heart problems. Estimates of sudden cardiac death rates among college athletes range from one in 43,000 to one in 83,000.
Perhaps the most infamous and high-profile instance of sudden cardiac death came in 1990, when Loyola Marymount basketball star Hank Gathers died from what many believe to be an abnormal thickening of the heart muscle. Tragedies have occurred locally, too, like in 2014 when Burrell football player Noah Cornuet collapsed at a preseason practice and died from a noncancerous tumor in his heart.
The benefit of such proactive tests is obvious — saving lives before they can be put in any kind of danger — but requiring every school to mimic Pitt’s approach presents obstacles.
Though it was downplayed by NCAA chief medical officer Brian Hainline, the most commonly cited hurdle is cost. Through its relationship with UPMC, Pitt pays about $200 per athlete for the tests. Short of such an arrangement with a hospital, however, those procedures are typically much more expensive.
Medical professionals also argue that EKG readings have a tendency to highlight something and prompt follow-up visits for people who are not at risk (known as a false positive).
“The downside of a false positive is it triggers further testing and it may unnecessarily sideline a player for some time until the definitive testing can be done,” Wong said. “When you look for rare diseases, you know you’re going to have a certain number of false positives. It’s kind of a whole concept of are we causing needless anxiety and generating a lot of downstream testing that doesn’t change our long-term management of that player?”
SOURCE: Craig Meyer, PIttsburgh Post Gazette