CHAPTER 27

FIT BUT UNHEALTHY—

Why Death Is the Ultimate Injury and Measures to Prevent It

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Tragically, an undetected injury can sometimes lurk as a ticking time bomb inside an athlete’s body. At the 2008 U.S. Olympic marathon trials, Ryan Shay, one of America’s best runners at age twenty-eight, collapsed and died about five miles into the race. New York City’s chief medical examiner said that Shay’s death was caused by “cardiac arrhythmia due to cardiac hypertrophy with patchy fibrosis of undetermined etiology. Natural causes.”

 

 

 

“Natural causes?” There’s nothing natural about a twenty-eight-year-old, exceptionally fit athlete’s heart stopping in the middle of competition. Shay’s irregular heartbeat stemmed from an abnormally enlarged and scarred heart.

Media coverage of athletes dying in sports as diverse as basketball, football, triathlon, and running is not uncommon. While we take physical injury in sports as an intrinsic part of competition, we’re bewildered when a seemingly healthy and young athlete drops dead. Through the looking glass of our sports culture, spectators and participants alike, we tend to view knee, back, shoulder, and other injuries as the normal “wear and tear” of supposedly giving 110 percent. But when the “injury” occurs in the heart, we are perplexed—and wonder why. The fact is, only about 2 percent of young athletes—under thirty years of age—who die suddenly are reported to show normal cardiac structure on standard autopsy examination. For the rest, there’s typically some form of heart disease present.