Medical examiner rules cardiac condition killed St. Joe's athlete

A hard-to-diagnose cardiac condition was responsible for the death of Ryan Gillyard, the 15-year-old who collapsed during a workout with his St. Joseph's Preparatory School football team four months ago, the Philadelphia Medical Examiner's Office said Wednesday.

Hypertrophic cardiomyopathy is a genetic condition that causes gradual thickening of the heart muscle and abnormalities in the electrical impulses that control the heart. Although fatalities are uncommon, it is the leading cause of sudden death among young athletes, whose conditions typically were previously unknown.

Gillyard, a freshman who lived in Upper Darby, collapsed and died April 18 during spring conditioning at the team's Cecil B. Moore Avenue practice field, less than a half-hour into drills. He was a linebacker and running back, and had been determined to play Division I college football.

Less than 0.2 percent of the general population has hypertrophic cardiomyopathy, according to the American College of Sports Medicine. It can occur at any age, but children and young adults are more likely to experience no symptoms. Yet, they are at higher risk of sudden death. Nearly half of the deaths nationally happen during or after physical activity.

Although hypertrophic cardiomyopathy often can be detected by EKG, cardiologists disagree about whether the diagnostic tool should be used more widely. Some studies have found false-positive rates of more than 15 percent, leading to unnecessary tests, higher costs, and possibly pulling children needlessly out of athletics.

Careful medical histories sometimes can suggest getting an EKG, but there may not be any advance signs.

John L. Moyer Jr., athletic trainer for the Wilson School District near Reading, said that physicals and family histories of the 700 athletes in his schools typically raise issues that suggest further testing in one or two students a year.

Across the country, high-profile deaths from the disorder - Loyola Marymount star Hank Gathers died of it in 1990 - sometimes spark calls to mandate EKGs for sports participation. But Moyer said that athletic trainers and physicians at two recent professional meetings in Pennsylvania generally agreed that a state mandate would be too costly to schools and families.

Moyer, who is president of the Pennsylvania Athletic Trainers' Society, said that no states require EKGs and he was unaware of any schools that did so locally.

He said that physicians believed that every secondary school should have a relationship with a licensed athletic trainer, and should have an automated external defibrillator on site. Nearly 90 percent of Pennsylvania districts have the former, Moyer said. Statistics were not immediately available for AEDs.

St. Joseph's has both, spokesman Bill Avington said, but the AED was not used when Gillyard collapsed during training. The reason was unclear.

"We have chosen not to comment on it because the situation involved a minor," Avington said.

Gillyard's family could not be reached for comment Wednesday.