CHICAGO–In the wake of
Gaines Adams' death of a cardiac arrest Jan. 17, the National Football League (NFL) may mandate an
ultrasound of the heart at next month's NFL Combine. But NFL Players
Association medical director Thom Mayer warned the decision would not be an
indication of regret and insisted the use of echocardiograms have been
discussed for several years.
"It takes my
breath away," Mayer told the Sun-Times when asked about Adams' death.
"I've got kids of my own, his age, so anytime you hear that one of your
own is gone, it's devastating.
"But it
doesn't mean it was a mistake (not to mandate echocardiograms) up to this
point."
Asked if the NFL
had administered an echocardiogram on Adams, who wrapped up his third NFL
season earlier this month, Mayer said, "Not to my knowledge.
"At the Combine,
he had an EKG," Mayer said of a simpler, non-invasive test that records
the electrical signals of the heart. "But to my knowledge, he never had
one (an ECHO)."
Based on
information provided to him, Mayer said the medical examiner who performed an autopsy
stated that Adams' enlarged heart would have been detected by an ECHO. But that
information still is not conclusive.
"Given the
current scientific knowledge base," Mayer said, "there's no
scientific evidence to indicate that if an ECHO had been done, that would have
made any difference in Gaines' outcome."
Adams underwent
multiple physicals, including one after the Tampa Bay Buccaneers traded him to
the Bears for a second round pick in October.
Whether to mandate
ECHOS, Mayer said, had nothing to do with cost (they cost more than $2,000
each, while an EKG runs about $50) but with the general unreliability
surrounding enlarged hearts.
"If I show
that scan to four different cardiologist, am I going to get the same result?
There's that issue," Mayer said. "Then what do you do with it? What
are we going to do with a positive result?"
That is the
challenge said Dr. Mark Estes, who helped develop the NBA's heart-testing
policy and was a part of a team of doctors who advised former Boston Celtics
star Reggie Lewis to stop playing because of a heart condition. Lewis sought a
second opinion that empowered him to keep playing, and he died after a cardiac
arrest a few months later.
"Additional
testing, like MRI, can be helpful," said Estes of Tufts Medical Center in
Boston, "or genetic or blood testing. But, in some instances, it's not
possible to know, with completely certainty, whether an athlete has an
enlargement from an athlete's heart or hypertropic cardiomyopathy.
The latter is a
thickening of the walls of the heart that obstructs the flow of blood to the
left side of the heart. The former, though, can be normal for highly trained
athletes, especially larger ones.
"This is an
art," Estes said of the evaluation of enlarged hearts, "but it's not
a precise science."
Estes, though, has
been pushing the sports leagues to mandate the ECHOS to help heart experts
determine what is a normal-sized heart for athletes.
"I agree with
Mark," Mayer said. "We don't have enough data for what is baseline
for someone of that size and someone of that level of conditioning."
In fact, Mayer
suggested that the NFL, NBA and NHL somehow figure out a way to share that
information.
"There should
be some level of data sharing," Mayer said, "to see what is
baseline."
SOURCE: Chicago Sun-Times