Cardiomyopathy killed Michigan high school basketball player, medical examiner rules

By Matt Helms

McClatchy Newspapers


DETROIT – The chief medical examiner for Ottawa County in western Michigan on Friday ruled the cause of death for high school basketball star Wes Leonard was cardiac arrest brought on by dilated cardiomyopathy, a condition the athlete may not have known he had.

The office of Dr. David A. Start, a forensic pathologist, released the findings Friday afternoon and said Leonard’s family has been notified. The condition enlarges and weakens heart muscles and can go undetected.

Leonard collapsed Thursday evening after he scored a game-winning shot. His death has brought fresh urgency to concerns about possibly hidden health dangers faced by young athletes.

Leonard, 16, collapsed on the basketball court at Fennville High School on Thursday night soon after he scored an overtime shot that clinched a 57-55 win over Bridgman – and a perfect season for the Holland-area school.

The player was tended to first by a parent EMT who happened to be at the game, and then by emergency personnel who arrived by ambulance and worked on Leonard for more than an hour, according to media accounts from the game.

Leonard arrived at Holland Hospital around 9:20 p.m. EST in cardiac arrest, and doctors were unable to restart his heart, hospital spokesman Tim Breed said Friday. He was pronounced dead around 10:40 p.m.

Fennville coach Ryan Klinger told the Holland Sentinel that Leonard had been recovering from the flu.

The game had brought seemingly the entire town to the high school gym, said Breed, who was there as well, cheering on the undefeated basketball squad.

“The hometown fans were just overjoyed,” Breed said. “Everybody was celebrating. The fans were going down to the gymnasium floor to celebrate with the players and the coaches. Within a matter of minutes, the gymnasium got very quiet. Wes had collapsed.”

The Holland Sentinel reported that at about 8:48 p.m., before the ambulance left the high school, an EMT appeared to hook Leonard to a defibrillator – a device that uses electricity to jolt hearts in life-threatening emergencies.

It is unclear from the media reports whether the school had an automated external defibrillator on hand for such emergencies, or whether the equipment was brought later by ambulance personnel. It is also unclear how much time had elapsed from the moment the player collapsed until the time the defibrillator was employed.

An increasing number of schools keep the devices on hand for emergencies not necessarily related to athletics, said Michigan High School Athletic Association spokesman John Johnson. He said the devices are not required at schools by law or regulation from the association, which has more than 760 public and private high schools statewide as members.

“But there are a number of schools which have secured portable equipment and sometimes aren’t able to go to the next the step and that is to have people trained to do it,” Johnson said.

In the past decade, there has been lobbying among some health professionals and parents to require schools to have such defibrillators on hand following the deaths of athletes in competition from previously undetected heart ailments. Likewise, there has been a push to require young athletes to undergo more comprehensive cardiac testing before they are allowed to compete.

Fennville schools officials couldn’t immediately be reached for comment Friday but issued a statement on the district’s Facebook page:
“The loss of Wes Leonard is a tragedy that has shocked our entire community. We feel tremendous sorrow for the Leonard family and everyone else who knew and cared for Wes. All of our schools have grief counselors available for students. We appreciate the outpouring of assistance from our fellow Allegan County school districts, as well as the many other expressions of support we have received.”

The school district – about 200 miles west of Detroit – canceled a high school play and a middle school dance scheduled for Friday night.

Jeff Miller, athletic director at Lawrence High School, which competes against Fennville as one of a dozen districts in the Southwestern Athletic Conference, said players across the area will wear black wristbands with Leonard’s initials on them during playoffs set to begin Monday.

Leonard was a formidable athlete on the basketball court and on the football field, Miller said. He was quarterback and captain of the school’s football team.

“We tried to figure out a way to contain him because you know you’re not going to stop him,” Miller said.

Dr. Marc Lahiri, a cardiac electrophysiologist for Henry Ford Hospital in Detroit, specializes in heart rhythm disorders, though he has no information about the circumstances of Leonard’s death.

Speaking generally, he said the two primary causes of sudden deaths from heart conditions – in which there were no previous symptoms – are hypertrophic cardiomyopathy, a thickening of the heart muscle that can cause cardiac arrest particularly during exertion, and genetic conditions including long QT syndrome, a problem with the electrical regulation of the heart.

Less common are congenital abnormalities, Lahiri said.

It is highly uncommon for healthy young people to die from flu, but “viral illnesses can cause cardiomyopathies for unknown reasons,” Lahiri said. “They can weaken the heart. When the heart is weakened, there is an increased risk of sudden death. It’s conceivable there could be a relationship.”

Detecting underlying heart conditions can be difficult because they often do not present symptoms until a sudden, possibly fatal event, Lahiri said.

Lahiri said he and other doctors want schools to make heart testing such as electrocardiograms, or EKGs, routine during physicals for school athletes. But he said the idea has been controversial because the testing is costly and can lead to false-positives that mean unnecessary additional testing.

Johnson, of the state athletic association, said schools require routine physicals yearly.
But laws and regulations “make no requirement of how extensive such a physical is,” Johnson said. “Having said that, we’ve been working with the Department of Community Health and have developed a new form for schools to use, if they choose, that could help them gather more health history about their young people who play athletics.”

Sudden cardiac deaths in young athletes are stunning and tragic but are about as common as lightning fatalities, according to a 27-year study of the issue released in 2009.

“Circulation: Journal of the American Heart Association” reported that 1,866 U.S. athletes ages 8 to 39 died from sudden cardiac arrest nationwide in 1980-2006. Cardiovascular diseases, often symptom-free and undiagnosed, were blamed in more than half of the deaths, with hypertrophic cardiomyopathy a leading cause.

The numbers are far below the death rates for young people from cancer, car crashes, homicides and other causes and were reported as similar to the rate of lightning-related deaths.

The study estimated that screening efforts such as EKGs would not reliably identify 30 percent of cardiovascular abnormalities that lead to sudden cardiac arrests.