Any parent who heard about the sudden death Saturday of St. Joseph's Prep athlete Ryan Gillyard will be asking the question:
Could that happen to my child?
Very unlikely, as the rate of sudden death in young athletes is reported to be as low as 1 in 200,000 people per year. Yet such cases are a chilling reminder that on rare occasions, someone who seems perfectly healthy can meet an abrupt end.
"People think, 'How could a 15-year-old die?' " said Perry Weinstock, chief of cardiology at Cooper University Health Care. "These are theoretically healthy people. They have a defective side of them that they didn't know about."
There was no word yet Monday on what killed Gillyard, of Upper Darby, according to the Philadelphia Medical Examiner's Office. The 15-year-old died during practice with the St. Joe's football team. His father, Jeffrey Gillyard, said his son collapsed suddenly while jumping rope.
The most common causes of sudden death in young athletes, by far, are a pair of heart disorders, according to a national registry created by the Minneapolis Heart Institute Foundation.
One is hypertrophic cardiomyopathy, the condition suffered by Loyola Marymount star Hank Gathers, who died in 1990. Collectively, various cardiac disorders account for more than half of sudden deaths in athletes, and hypertrophic cardiomyopathy is blamed for more than one-third of those.
The other main culprit is an anomaly of one or more coronary arteries, accounting for 17 percent of sudden cardiac deaths in young athletes, according to the national registry. A much less common condition associated with sudden death in athletes is sickle-cell anemia, a genetic disorder found in just two dozen out of more than 2,000 people in the death registry, which dates to 1980.
Hypertrophic cardiomyopathy, marked by thickened walls of the heart and "disorganized" ventricular cells that are associated with an abnormal rhythm, is found in 1 in 500 people but is not fatal in most, Weinstock said.
The disorder can be detected with an electrocardiogram (EKG), but there is some debate among cardiologists as to whether widespread use of this screening tool is a wise idea, given a relatively high rate of false positives - patients who test positive for the condition but later turn out to be fine.
The American Heart Association recommends an EKG only if it appears warranted after a thorough physical and a careful analysis of family history. Physicians look for warning signs such as a history of chest pain or dizziness, as well as any evidence of heart problems in relatives, said Kevin Harris, a cardiologist with the Minneapolis Heart Institute Foundation.
For EKG exams, some studies have reported rates of false positives above 15 percent, in part because the EKGs for athletes, even when they have healthy hearts, can appear different from those of healthy non-athletes. The concern with false positives is that those patients will then have to undergo additional tests, suffering undue anxiety and increased cost.
David M. Shipon, a preventive and sports cardiologist at Thomas Jefferson University Hospital, said one option is to have the EKGs analyzed by experts who are specially trained to read such results for athletes.
That will happen May 30 at Temple University's Liacouras Center, where the nonprofit Athlete Health Organization is offering free sports physicals to student athletes. Those interested must sign up in advance.
Shipon, who in addition to his job as cardiologist is also the chief executive officer of the nonprofit, said sign-up information is available from school athletic directors and at http://athletehealth.org.
Weinstock, the Cooper cardiologist, said another key is for parents to be very careful in filling out paperwork describing medical histories for their child's physician. "A lot of those forms are kind of filled out quickly," he said, yet they can be vital to helping doctors spot potential trouble.
Still, doctors say, it's impossible to completely avoid sudden crises like the one that apparently killed Ryan Gillyard.
"No matter what we do, there's going to be a certain amount of deaths from this, because we can't find every case," Weinstock said. "But we can do a better job."
Ryan Gillyard Services
A memorial service for St. Joseph's Prep freshman Ryan Gillyard, who died Saturday morning after a spring football workout, is scheduled for 2 to 4:15 p.m. Friday at the Church of the Gesu on the school's campus. The service is open to the Prep community.
A viewing will be held from 9 to 10:45 a.m. Saturday at the Funeral Home of John Stretch, 236 East Eagle Rd., Havertown.
The funeral Mass will be at 11 a.m. Saturday at St. Denis Catholic Church, 2401 St. Denis Lane, Havertown.