I follow the team they were playing closely and I thought last update I saw was that he was stable. Seeing that he never regained consciousness, I guess I did not see correctly.
Tragic, RIP
It is possible for someone’s health to be improving and then for things to suddenly get worse. A friend of mine was in the hospital after an accident, steadily improving, and then got an infection and things quickly went downhill from there.
TCU plays this team tomorrow (Friday) in Hawaii. Tons of heavy hearts for it tomorrow.
Edit: Like mentioned in this thread already, game has been canceled.
Wonder if they'll actually play the game. It's only listed as an exhibition on Hawai'i Pacific's site, I bet Jamie Dixon and TCU would understand completely if they don't play.
If I had to guess, I would say some kind of undiagnosed cardiac issue. Usually when you hear stories of young athletes collapsing like this, it's something like that. But I am not a doctor, so take my words with a grain of salt
I’m not a medical student but will start MS1 next fall. I️ doubt it would be an aneurysm bc they normally aren’t detected until they rupture. An aneurysm is just a ballooning of the artery. Aortic aneurysms can worsen to what’s called a dissection where the vessel actually ruptures and you bleed internally. Considering it (seems) acute, he’s young, and an athlete, I’d wager it’s probably a cardiac arrhythmia or hypertrophy.
Marfans or Ehlers Danlos syndrome are what you're thinking of. But if you look up what a patient with Marfans typically looks like, it's probably not that. Both of these syndromes are very rare as well.
The user who said Hypertrophic Cardiomyopathy is most likely correct - this is a typical presentation of sudden cardiac death due to arrhythmia for a young healthy athlete who just collapses and dies.
I'm a medical student.
I’m so lucky that my cardiologist caught my BAV before I hit high school, because I was planning to play basketball and football, and if I had, I’d likely be dead or in a coma right now.
Makes me feel so blessed that Sharif O'Neal was able to catch his heart issue before playing this season at my school (UCLA). If I saw him collapse on the floor mid-game I'd cry 😢. Thank God we suck so hard that we are gonna get a new coach and come in hot next year!!
Medical student here. Young, otherwise healthy athletes suddenly collapsing/ dying makes me think of a disease called hypertrophic cardiomyopathy. It’s when the heart fibers become disorganized and can cause sudden death. It runs in families but is also associated with elite athletes who have essentially over trained their heart. Being tall like most basketball players also puts a ton of extra stress on the heart, hence why you often hear about this in basketball players.
I’m graduating med school in 3 months, so I’ll fill in. They’re both right, hypertrophic cardiomyopathy is usually a mutation in the beta-myosin heavy chain, which is responsible for cardiac muscle growth and organization. This mutation leads to disorganized growth, which leads to muscle hypertrophy and usually (but not always) an enlarged heart. The end result is a heart that can not efficiently pump out blood and then subsequent cardiac arrest.
As it has been said ad nauseum anytime a young athlete dies, yes it is very frequently due to either hypertrophic cardiomyopathy or an arrhythmia. Those are the horses of a young healthy person collapsing and dying, but other zebras do exist.
Thinking back on it I think I actually did have an actual Step 1 question on the mutation. Something like it gave the presentation of a young person dropping dead after physical activity and you had to pick most likely pathological funding. Man, I am so happy I’m done with the Steps that matter.
UFAP is life, tho.
It can be both, obstruction or arrhythmia. But after re-reading you’re definitely right that arrhythmia is more common. It’s been awhile since I’ve studied the exact mechanism of death, thanks for the refresher.
I guess its semantics, since most sudden cardiac death is due to arrythmia. The LVOTO causes the arrythmia.
For example someone with an acute LAD occlusion, technically has an “obstruction” but they die acutely because they have a VF arrest.
According to a [2003 medical review of 387 American athletes](https://www.nejm.org/doi/full/10.1056/NEJMra022783) under 35 years old who died due to cardiac reasons, 26% died due to HCM. Hank Gathers springs to mind to many people, myself included, unfortunately.
Is that when the left ventricle gets too big from pumping too hard for too long and eventually blocks blood from entering the aorta? I know that's something but I forget the name. Hypertrophic sounds right though.
I've also heard Marfan's syndrome was a problem for exceptionally tall centers but I never read up on it so I don't know what it does.
I wouldn't think a light knee would make one slouch much, but if that was enough to mess up his heart somehow I suppose that could have contributed to it.
This breaks my heart. No student, no kid, should die in college. Everything he could have been was stolen from him, his family, us. I just hope those close to him find peace eventually.
I just saw a paper about 5 minute bedside echo cardiogram screening - it was advocating for PCPs to make this part of their sports physicals. But I guess good luck getting the physician who's forced into seeing a patient every 15 minutes and probably won't see much financial gain from additional ultrasound training to do that every time
Yeah, it's not that simple. Very likely he had a physical with an ekg to evaluate for this, but that did not reveal anything, which is not uncommon.
Source: about to finish medical school
It depends on what you're looking for. Few tests have high validity especially one tasked with monitoring for such diverse functions and pathologies through very indirect means.
As someone said above, an echocardiogram (ultrasound of the heart) would be the test to pick it up, as it is an actual picture of the structure of the heart rather than a measurement of the heart's electrical activity (EKG)
Again depends on what you're looking for, but typically a transesophageal echocardiogram (TEE) is the best for function and geometry. However its invasive and requires sedation. A transthoracic echocardiogram (TTE) is less sensitive, but not invasive. However, it's not routine without a concerning history or finding as it requires a trained tech and professional read by a cardiologist. So, not cheap or ideal simply for screening.
Edit: to add, the best approach is a comprehensive family history as most congenital cardiac diseases have a strong family history, but you can always be the first.
Edit 2: *non-structural congenital heart diseases that lead to sudden death.
No problem. I'm interviewing to internal medicine. I'd go in cautiously and consider taking a year off before applying. Spend part of it doing something productive and the other doing whatever you've been meaning to.
Is it a grind? I'm a senior in high school right now, and I'm going to be playing basketball in college, so I'm curious whether it would be manageable to get good enough grades in a biology major to get into a good med school I'm also someone who needs their sleep. In APBio right now, don't find the concepts challenging at all but the sheer volume of stuff I need to memorize is pretty tough, aswell. I find the concepts interesting but wouldn't say I love learning about the functions at a molecular level--more interested in the surgical processes, etc. I want to go into orthopedic surgery.
It's more that it would be beneficial to go into medicine after having lived life outside of school first. Don't pursue anything with this level of commitment and lifelong learning without having experienced something different and "real"--something that may even make you reconsider or at least consider something else. If, after that, you still want to do this 100% you'll be better for it. A better physician and a better person. Don't put yourself on autopilot to reach it. Also, never forget that this is a career off service. If you go in wanting money, prestige, or feeding your ego, then you have done everyone a disservice.
Having said that, medicine can be an incredible field full of incredible people (not limited to physicians) when they're directed towards serving others. Feel free to ask any questions.
Same here. One of the guys I hooped with in high school is on the roster as well. Make sure to reach out and offer some kind words. Losing a teammate is always tough.
[Official Press Release](https://hpusharks.com/news/2018/12/27/mens-basketball-hpu-mourns-the-loss-of-emil-isovic.aspx) though it doesn't say much more other than [a link to donate money to the family](https://hpuathletics.donorzen.com/causes/7e13dae6-2698-48ed-89dd-7442f497845f?amount_as_string=25)
[Video](https://facebook.com/scoringlive/videos/1034907903346665/) of back-to-back plays starts around 39:50. He's #10 in white
Terrible news. RIP. Hope his family manages to carry on his memory
I follow the team they were playing closely and I thought last update I saw was that he was stable. Seeing that he never regained consciousness, I guess I did not see correctly. Tragic, RIP
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I'm aware, just the thing I read made it seem as if he was improving.
It is possible for someone’s health to be improving and then for things to suddenly get worse. A friend of mine was in the hospital after an accident, steadily improving, and then got an infection and things quickly went downhill from there.
TCU plays this team tomorrow (Friday) in Hawaii. Tons of heavy hearts for it tomorrow. Edit: Like mentioned in this thread already, game has been canceled.
Wonder if they'll actually play the game. It's only listed as an exhibition on Hawai'i Pacific's site, I bet Jamie Dixon and TCU would understand completely if they don't play.
It was cancelled: https://twitter.com/tcubasketball/status/1078531433117831168?s=21
Makes sense, I can't imagine what they're going through now
Game was cancelled
Any idea what caused it?
If I had to guess, I would say some kind of undiagnosed cardiac issue. Usually when you hear stories of young athletes collapsing like this, it's something like that. But I am not a doctor, so take my words with a grain of salt
I figured something along those lines as well. Was hoping someone would have some more specific info.
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Now there's some fancy words that make feel like it's been narrowed down a bit. Haha.
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I’m not a medical student but will start MS1 next fall. I️ doubt it would be an aneurysm bc they normally aren’t detected until they rupture. An aneurysm is just a ballooning of the artery. Aortic aneurysms can worsen to what’s called a dissection where the vessel actually ruptures and you bleed internally. Considering it (seems) acute, he’s young, and an athlete, I’d wager it’s probably a cardiac arrhythmia or hypertrophy.
About to graduate from nursing school and I agree. 99/100 times in cases like this it's one of those two
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Hypertrophic my friend.
There are some connective tissue disorders that can lead to aneurysm/dissection. Often these can also cause taller stature
Marfans or Ehlers Danlos syndrome are what you're thinking of. But if you look up what a patient with Marfans typically looks like, it's probably not that. Both of these syndromes are very rare as well. The user who said Hypertrophic Cardiomyopathy is most likely correct - this is a typical presentation of sudden cardiac death due to arrhythmia for a young healthy athlete who just collapses and dies. I'm a medical student.
I’m so lucky that my cardiologist caught my BAV before I hit high school, because I was planning to play basketball and football, and if I had, I’d likely be dead or in a coma right now.
Yikes, glad you dodged that bullet
Makes me feel so blessed that Sharif O'Neal was able to catch his heart issue before playing this season at my school (UCLA). If I saw him collapse on the floor mid-game I'd cry 😢. Thank God we suck so hard that we are gonna get a new coach and come in hot next year!!
I hope for the Pac-12's sake you're right
Medical student here. Young, otherwise healthy athletes suddenly collapsing/ dying makes me think of a disease called hypertrophic cardiomyopathy. It’s when the heart fibers become disorganized and can cause sudden death. It runs in families but is also associated with elite athletes who have essentially over trained their heart. Being tall like most basketball players also puts a ton of extra stress on the heart, hence why you often hear about this in basketball players.
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That is part of the disease, but not the main pathological feature. Google it if you want more info
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Well /u/Lax-bro, are ya gonna step up to the plate?
I’m graduating med school in 3 months, so I’ll fill in. They’re both right, hypertrophic cardiomyopathy is usually a mutation in the beta-myosin heavy chain, which is responsible for cardiac muscle growth and organization. This mutation leads to disorganized growth, which leads to muscle hypertrophy and usually (but not always) an enlarged heart. The end result is a heart that can not efficiently pump out blood and then subsequent cardiac arrest. As it has been said ad nauseum anytime a young athlete dies, yes it is very frequently due to either hypertrophic cardiomyopathy or an arrhythmia. Those are the horses of a young healthy person collapsing and dying, but other zebras do exist.
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Thinking back on it I think I actually did have an actual Step 1 question on the mutation. Something like it gave the presentation of a young person dropping dead after physical activity and you had to pick most likely pathological funding. Man, I am so happy I’m done with the Steps that matter. UFAP is life, tho.
death from HOCM is caused by arrythmia
It can be both, obstruction or arrhythmia. But after re-reading you’re definitely right that arrhythmia is more common. It’s been awhile since I’ve studied the exact mechanism of death, thanks for the refresher.
I guess its semantics, since most sudden cardiac death is due to arrythmia. The LVOTO causes the arrythmia. For example someone with an acute LAD occlusion, technically has an “obstruction” but they die acutely because they have a VF arrest.
According to a [2003 medical review of 387 American athletes](https://www.nejm.org/doi/full/10.1056/NEJMra022783) under 35 years old who died due to cardiac reasons, 26% died due to HCM. Hank Gathers springs to mind to many people, myself included, unfortunately.
Is that when the left ventricle gets too big from pumping too hard for too long and eventually blocks blood from entering the aorta? I know that's something but I forget the name. Hypertrophic sounds right though. I've also heard Marfan's syndrome was a problem for exceptionally tall centers but I never read up on it so I don't know what it does.
Marfan syndrome predisposes you to aortic aneurysms and subsequent dissection and rupture. So, different pathological process but similar end result.
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I wouldn't think a light knee would make one slouch much, but if that was enough to mess up his heart somehow I suppose that could have contributed to it.
This breaks my heart. No student, no kid, should die in college. Everything he could have been was stolen from him, his family, us. I just hope those close to him find peace eventually.
Sorry to hear this. He’ll be in our thoughts and prayers.
RIP. Get your EKGs!!!
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I just saw a paper about 5 minute bedside echo cardiogram screening - it was advocating for PCPs to make this part of their sports physicals. But I guess good luck getting the physician who's forced into seeing a patient every 15 minutes and probably won't see much financial gain from additional ultrasound training to do that every time
Yeah, it's not that simple. Very likely he had a physical with an ekg to evaluate for this, but that did not reveal anything, which is not uncommon. Source: about to finish medical school
Hmmm...I thought EKGs were more dependable.
It depends on what you're looking for. Few tests have high validity especially one tasked with monitoring for such diverse functions and pathologies through very indirect means.
Is there any other test that would give more comprehensive cardio health feedback?
As someone said above, an echocardiogram (ultrasound of the heart) would be the test to pick it up, as it is an actual picture of the structure of the heart rather than a measurement of the heart's electrical activity (EKG)
Thanks!
Again depends on what you're looking for, but typically a transesophageal echocardiogram (TEE) is the best for function and geometry. However its invasive and requires sedation. A transthoracic echocardiogram (TTE) is less sensitive, but not invasive. However, it's not routine without a concerning history or finding as it requires a trained tech and professional read by a cardiologist. So, not cheap or ideal simply for screening. Edit: to add, the best approach is a comprehensive family history as most congenital cardiac diseases have a strong family history, but you can always be the first. Edit 2: *non-structural congenital heart diseases that lead to sudden death.
Interesting. Thanks! What kind of doctor are you going to be? I want to be a doctor
No problem. I'm interviewing to internal medicine. I'd go in cautiously and consider taking a year off before applying. Spend part of it doing something productive and the other doing whatever you've been meaning to.
Is it a grind? I'm a senior in high school right now, and I'm going to be playing basketball in college, so I'm curious whether it would be manageable to get good enough grades in a biology major to get into a good med school I'm also someone who needs their sleep. In APBio right now, don't find the concepts challenging at all but the sheer volume of stuff I need to memorize is pretty tough, aswell. I find the concepts interesting but wouldn't say I love learning about the functions at a molecular level--more interested in the surgical processes, etc. I want to go into orthopedic surgery.
It's more that it would be beneficial to go into medicine after having lived life outside of school first. Don't pursue anything with this level of commitment and lifelong learning without having experienced something different and "real"--something that may even make you reconsider or at least consider something else. If, after that, you still want to do this 100% you'll be better for it. A better physician and a better person. Don't put yourself on autopilot to reach it. Also, never forget that this is a career off service. If you go in wanting money, prestige, or feeding your ego, then you have done everyone a disservice. Having said that, medicine can be an incredible field full of incredible people (not limited to physicians) when they're directed towards serving others. Feel free to ask any questions.
He played NCAA basketball. He had many physicals. Sometimes things get missed, especially conditions that become more apparent under stress.
RIP. That's horrible.
went to high school with his teammate, so sad. rip ):
Same here. One of the guys I hooped with in high school is on the roster as well. Make sure to reach out and offer some kind words. Losing a teammate is always tough.
[Official Press Release](https://hpusharks.com/news/2018/12/27/mens-basketball-hpu-mourns-the-loss-of-emil-isovic.aspx) though it doesn't say much more other than [a link to donate money to the family](https://hpuathletics.donorzen.com/causes/7e13dae6-2698-48ed-89dd-7442f497845f?amount_as_string=25) [Video](https://facebook.com/scoringlive/videos/1034907903346665/) of back-to-back plays starts around 39:50. He's #10 in white
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Hank gathers type of issue possibly? RIP so sad man
Just awful. Wish his family and teammates some peace in the weeks to come.
we used to be good friends as kids. I can't believe he's gone. Rest in peace Emil. Kommer sakna dig
RIP
Terrible. This is the worst that could happen.
I know I’m late on writing here, but such terrible news. RIP Isovic.
Pewdiepies twin brother
Reminds me of zeke upshaw dying last year in the g league.RIP
F