On April 15, Katherine Scholtz from Kentucky underwent surgery to repair two holes in her heart. Despite being a Special Olympics athlete since age 8 (she is now 31), her heart defects had never been discovered.
Katherine Scholtz, an athlete with Special Olympics Kentucky, participates in swimming, bowling and golf. In December, a cadiologist discoverd two holes in her heart, which could have caused her to suffer cardiac arrest while training or competing.
In December, however, she went to her physician for a three-year physical. When her physician learned she had never had an EKG, he referred her to a cardiologist who discovered the defect as well as an enlargement of the right side of her heart caused by increased cardiac stress.
Fortunately, the condition was discovered before it caused problems while she was training or competing. Now, her doctors expect her to recover fully and return to her sports and pre-surgery activities.
“She is tired, of course, but doing well,” Katherine’s mother Kathy said. “What’s bothering her right now is that she is not used to lying in bed. She is not a sedentary person.”
While both the medical and sports communities have recently started paying more attention to athlete cardiac risks, neither has developed cardiac screening protocols for athletes with intellectual disabilities.
“This is an area of medicine where we just don’t have that much guidance,” said Special Olympics Global Clinical Advisor Dr. Matt Holder.
Since 2005, Dr. Holder has been developing and testing more rigorous medical screening protocols for athletes with intellectual disabilities. In 2007, with the official launch of the MedFest program, the data from those new protocols indicated that Special Olympics athletes could be at an even higher rate of cardiac risk than other athletes.
“When we looked at the data, we noticed that many of the causes of intellectual disabilities were highly associated with cardiac defects that could put our athletes at risk. Moreover, many of the medications that our athletes take could further increase that risk,” Dr. Holder said.
With that data in mind, Dr. Holder, Dr. Gonzalo Laraburre (Healthy Athletes regional coordinator for Latin America) and Dr. Thelma Torres (MedFest clinical director for Special Olympics Mexico), organized the first test in September 2009 of a new cardiac screening protocol developed specifically for Special Olympics athletes.
“Thanks to the hard work of Dr. Torres, and our event sponsor Novartis Mexico, we were able to find enough volunteer cardiologists and donated EKG equipment to screen over 300 athletes,” Dr. Holder said.
The results of the screening showed that the new MedFest protocols alone were 100% more effective in detecting possible cardiac disorders than previous methods. Additionally, when EKG was added to the screening, the protocol was more than 300% more effective.
“Overall, it looks like around 3% of our athletes could have some kind of significant heart condition that should be followed by a cardiologist,” Dr. Holder said, adding that more data is needed. “We took a great first step, and now we are planning to look at this issue in more depth. The protocols that we are testing now aren’t perfect, but I think that with a little more study, we’ll be able to greatly reduce the risk of cardiac events in our athletes.”
Based on this work, Healthy Athletes is now developing models to support Programs in implementing similar programs. Programs who are able to partner with a hospital or other sponsor to provide the additional equipment and that can support the extra time and volunteers necessary to conduct the screening (The addition of cardiac screening adds approximately six minutes to the overall MedFest screening.) will be able to add this as a optional module for Healthy Athletes MedFest.
Additionally, Dr. Holder advises all athletes and coaches to pay close attention to symptoms that could signal a possible heart problem. Such symptoms might include: chest pain, light headedness, loss of consciousness, a very rapid pulse or an irregular pulse.
Programs who are interested in learning more about new MedFest protocols and adding it to their MedFest events can contact Dr. Holder at firstname.lastname@example.org.