Damar Hamlin and Other Athletes With Heart Problems - Health Central
As the world waits word of this player's condition, we examine how, why, and to whom serious heart issues can strike.
On January 2, professional football player Damar Hamlin, 24, of the Buffalo Bills collapsed on the field after what looked to be a routine tackle in the first quarter of a game in Cincinnati against the Bengals. He briefly rose to his feet, then fell backward to the ground before thousands of fans, including his mother, in the stadium, plus millions more watching at home on live television. According to multiple reports, Hamlin went into cardiac arrest, which occurs from electrical dysfunction in the heart that causes it to stop beating.
On Tuesday evening, Hamlin's uncle Dorrian Glenn told CNN that Hamlin was resuscitated twice—first by medical staff on the field, who were able to restore his heartbeat, and a second time shortly after arriving at the University of Cincinnati Medical Center (UCMC), where he was transported to undergo treatment and testing. Once there, CNN reports that he was sedated, is being treated while lying on his stomach (prone) to promote optimal oxygen flow, and is on a ventilator—a "good sign," Glenn noted, adding that his ventilator use was down by 50% within 24 hours of the collapse, with doctors trying to get the young athlete to breathe on his own.
On Thursday afternoon, the UCMC held a press conference with Hamlin's physicians, who told reporters that while they are still running tests to determine the cause behind Hamlin's cardiac arrest, he remains "critically ill" nearly three days after the incident but is showing "substantial improvement" over the past 24 hours. He is slowly awakening and appears to be neurologically intact. Hamlin even communicated in writing—his breathing tube prevents him from speaking—with those at his bedside in the ICU on Wednesday evening, his doctors noted, asking who won the game.
And on Friday morning, the Buffalo Bills tweeted that Hamlin's breathing tube was removed overnight.
Top cardiologists (none of whom are treating the player) have made the news rounds to posit theories about Hamlin's cardiac episode based on the available information, including blunt force trauma that may have triggered ventricular fibrillation or an aortic tear, or some unknown (and previously undiagnosed) heart issue, like hypertrophic cardiomyopathy (HCM).
"HCM is the most common cause of sudden cardiac death in young athletes," explains Sirish Vullaganti, M.D., director of heart failure at Lenox Hill Hospital in New York City. Research shows that HCM most often strikes athletes who are 35 and under—in other words, in the prime of their lives, like Hamlin is.
"For any person or athlete who suffers a cardiac arrest, the most important factor is ... early CPR [cardiopulmonary resuscitation] and use of an automatic external defibrillator [AED] when needed," Dr. Vullaganti says. Such interventions can reduce "the chances of permanent neurologic injury, since the brain does not receive oxygen while the heart is not pumping." Once the heart is beating normally, attention shifts toward the stabilization of other organs, he adds. "Most people will require a mechanical ventilator to take over the role of the lungs while the brain has time to recover. The body's temperature is also regulated by medical teams to reduce the risk of brain injury, and patients are kept chemically sedated during this process."
For this and other reasons, Dr. Vullaganti explains, "it is very difficult to have a prognosis in the first 72 hours. We typically slowly remove sedation after this window to assess for neurologic recovery. During this time we also pursue diagnostic testing to determine the cause of the cardiac arrest" and treat appropriately.
As the sporting world, the city of Buffalo, and leagues of other concerned fans wait anxiously for additional updates of Hamlin's gradually improving condition, what's clear is that this top player still has a long road of recovery ahead.
What's more, while Monday night's tragic incident was unusual—the only other NFL player to collapse in a similar way was Chuck Hughes, a 28-year-old wide receiver for the Detroit Lions, who died in 1971 within an hour of suffering a heart attack on the field from a previously undiagnosed blocked coronary artery—heart problems among leading athletes across many types of sport are not unheard of.
Sadly, some of them, as in Hughes' case, proved fatal. A few top athletes have famously gone on to thrive after a serious heart diagnosis and/or episode. Hamlin's supporters are praying that his fate delivers him to a similar, happy outcome—past the goal line to a long and healthy life. We share some of their stories, tragic and triumphant, here.
Zeke Upshaw
Upshaw, a professional basketball player, went into sudden cardiac arrest on March 24, 2018, while playing for the Grand Rapids Drive, an NBA Development League team. The 26-year-old died two days later. According to ESPN, whose reporters spent months combing through Upshaw's medical records, the player's body was examined by the Kent County Medical Examiner's Office, who noted that Upshaw had arrhythmogenic right ventricular cardiomyopathy (ARVC). "But several other top cardiologists said they were convinced Upshaw had a similar disease, hypertrophic cardiomyopathy (HCM)," the same ESPN article states. ARVC is an inherited heart disorder, per Johns Hopkins Medicine, that can cause ventricular tachycardia, or VT (a rapid, irregular heartbeat, a type of arrhythmia) and sudden cardiac arrest (SCA). HCM is also an inherited heart disorder that causes the heart muscle to thicken, which can then trigger VT, stopping the heart. According to the American Heart Association, both conditions are rare and often go undiagnosed.
Omar Carter
Carter mainly played basketball in other countries—Brazil and the Dominican Republic—but it was during a semi-professional game in Charlotte, NC, in 2013 when his heart stopped beating for 13 agonizing minutes. The cause: SCA, or sudden cardiac arrest. Carter, 25 at the time, has HCM. He was among the 10% of HCM patients to survive SCA with immediate medical intervention, followed by a medically induced coma. Exercise, say experts, is a common trigger for SCA in people with HCM. And it most commonly occurs during sports like soccer, basketball, track, and football. "It can happen in any exercise, but it's more likely in these," says cardiologist David Owens, M.D., director of the HCM clinic at University of Washington Medicine's Heart Institute in Seattle. "There might be something about the heart rate going up and down." Carter went on to found the Omar Carter Foundation, which works to raise awareness of heart health issues in young people and increase cardiopulmonary resuscitation (CPR) training to save athletes' lives.
Gaines Adams
A defensive end for the Chicago Bears, Adams died of SCA at his family's home in Greenwood, SC. He was 26. Adams's autopsy revealed that he had an enlarged heart, also known as cardiomegaly. An enlarged heart is not a disease itself but a symptom of another condition, according to the Mayo Clinic. High blood pressure, congenital heart defects (a heart problem you're born with), damage caused by a heart attack, and numerous other conditions can lead to an enlarged heart. In Adams's case, his family was not aware of any heart condition prior to his death.
Marc Vivien Foe, Miklos Feher, and Antonio Puerta
These three international soccer players died during matches within three years of each other, during the years 2004 to 2007. Foe, 28, a two-time World Cup player from Cameroon, and Feher, 24, from Hungary, were both diagnosed with HCM after their deaths, and it was believed that VT stopped their hearts, according to a 2019 study of athletes and sudden cardiac death. The same study reported that Puerta, a 22-year-old from Spain, had arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). It was discovered during his autopsy. Like HCM, this rare, inherited disorder can cause VT and sudden cardiac death (SCD) in young people who appear healthy. Some experts advise cardiac screening for all athletes. "We recommend, though not everyone agrees, that all athletes should have an electrocardiogram, because an EKG shows whether they have HCM or some other form of heart disease," says cardiologist Robert Myerburg, M.D., a professor of medicine at the University of Miami Miller School of Medicine in Florida.
Ryan Shay
A champion marathon runner, Shay collapsed in Central Park in New York City on November 3, 2007, during the trials for the 2008 U.S. Olympic team. His autopsy determined that his enlarged and scarred heart caused a fatal arrhythmia. Scar tissue in the heart, whatever the cause, can disrupt the electrical signals that help the heart maintain a healthy rhythm. The arrhythmias that result, including VT, can be fatal. Shay had been diagnosed with an enlarged heart as a teenager, but it had never affected his running career, according to reports. The source of the scar tissue remains a mystery.
Flo Hyman
Named to Sports Illustrated magazine's top 100 female athletes of the 20th century—she earned a ranking of #69—Hyman was a three-time All-American champion volleyball player who won a silver medal at the 1984 Olympic games in Los Angeles. She suffered SCA and died on January 24, 1986, during a match in Japan. Doctors determined that she had undiagnosed Marfan syndrome, a rare genetic condition. Her disease caused an aortic dissection, in which the heart's main artery, the aorta, tears. When this happens, blood flow to the rest of your body can slow or stop, according to the Cleveland Clinic. This is life-threatening and requires immediate treatment.
Jared Butler
Pro basketball player Butler, 22, a guard for the Utah Jazz, was diagnosed with HCM at age 17 as part of a routine medical exam. He'd never had symptoms, which can include fatigue, shortness of breath, and fainting, and he eventually was cleared to play. He joined the Division 1 Baylor University basketball team. In 2021, he helped lead his team to an NCAA championship title. After graduating college, he was drafted to the Jazz. In addition to his basketball career, Butler helps to raise awareness about HCM by promoting the website Could It Be HCM? Diagnosis of HCM is critical, according to Dr. Villuganti, who says that life expectancy for those with HCM is the same as for those with a healthy heart once HCM has been diagnosed. Treatment may include an implantable defibrillator, a device which shocks the heart back to a normal rhythm if it detects a dangerous arrhythmia such as VT.
Roger Black
An Olympic silver medalist in the 400m sprint—he competed for England in 1996—Black was born with aortic valve regurgitation, which was diagnosed when he was 11. This condition causes the aortic valve to leak, allowing blood to flow in two directions. In a healthy heart, blood flows in only one direction: out of the heart to the rest of the body and then back again in an ongoing loop. According to the American Heart Association, a leaky aortic valve forces the heart to work harder than it should. This can lead to heart failure. Black, now 55 and retired from competition, jogs for 30 minutes a day.
So what's the takeaway from all these athletes, many of whom lost their lives at what should have been the peak of their athletic powers? Even those who are presumably in the best shape of their lives—and certainly far fitter than most of us mere mortals—are not immune to heart disease in its various incarnations. Sometimes genetic, sometimes brought on by the violence of contact sports or the physical strain from endurance sports, heart issues are, quite literally, a matter of life and death. No matter what shape you're in, make a point of getting your heart checked out at your annual physical. And if you're not currently getting annual physicals, make 2023 the year to start.
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