The heart of an athlete
Alex Corrance was an elite athlete. As a defenseman for the Mississauga Rebels Midget AAA team, he worked out four to six times a week to keep in shape. "Alex just lived for hockey," says his father, Alan. "If it wasn't ice hockey in the winter, it was roller or ball hockey in the summer, hanging with the guys and having a good time.” At 6’2” 190 lb, the 17-year-old was certainly not someone you’d ever suspect of having a fatal heart condition.
The day after Christmas in 2006, Alan drove Alex to a hockey tournament. “He was fine. He was excited about playing, joking around with his teammates right before the game.” Just 10 minutes into the first period, the game was stopped. Alan was watching up in the stands when he realized that a player was down. As manager of his son’s hockey team, Alan rushed down to the ice to see who it was. “I was checking out all the players and realized that it was my son. This was really unusual because in all the years Alex played he was rarely injured.”
But Alex hadn’t been hit. According to eyewitnesses, he had just collapsed onto the ice. Both of the team trainers immediately performed CPR and used an Automated External Defibrillator (AED) available at the arena. Off-duty firefighters and nurses assisted until paramedics arrived. In emergency, hospital staff continued to try to resuscitate Alex but were not able to revive him. “The ER doctor called me into the room to say goodbye to him,” says Alan.
A coroner’s report a few days later identified the cause of Alex’s death: an inherited heart condition known as Arrythmogenic Right Ventricular Dysplasia (ARVD). This is a disease of the heart muscle in which fatty scar tissue replaces the muscle cells of the right ventricle, causing abnormal heart rhythms. Alan, along with Alex’s mother Debbie, were stunned. How could the heart of their extremely fit son simply stop working? “We kept wondering why Alex could have had a bad heart. Turns out, elite training can make ARVD worse.”
Dr. Andrew Krahn, a specialist in heart rhythm disorders at the London Health Sciences Centre, and a Foundation-funded researcher explains: “In ARVD, intense exercise causes the heart cells to pull apart because the ‘Velcro’ that holds them together is weak, causing scarring that builds up more rapidly than with moderate forms of exercise. Alex was a super hockey player and his extensive conditioning made his heart vulnerable to cardiac arrest.”
ARVD is difficult to diagnose. Although there are some subtle symptoms, more than 50% of those with the condition exhibit no warning signs – just like Alex. The symptoms include fainting for unusual reasons – without warning or during physical activity. Sadly, sudden death was the only symptom Alex ever had. And because ARVD runs in families, parents should think back to stories of relatives who died suddenly for no apparent reason at a young age.
In the Corrance’s family, Debbie’s grandmother had passed away unexpectedly in her 30s of unknown causes. In fact, when Dr. Krahn conducted tests on both Alan and Debbie, ARVD was found in her genes.
Dr. Krahn advises that if your child has had unusual fainting spells and you have had relatives that have died young, you should get the whole family checked out. The first line of testing may include a detailed history, physical examination and performing an electrocardiogram (ECG).
If diagnosed in time, teens with ARVD can manage with medication and participate in moderate activities such as biking and playing baseball. In some cases, a defibrillator may need to be implanted to monitor and treat the heart.
Alan and Debbie hope advances are made not only in the treatment of those with degenerative heart conditions, but also in their detection. "It means a lot to us in getting the awareness out, and, hopefully, medical research will find some way of detecting and improving the treatment," he said. The Corrances have kept Alex’s memory alive by hosting an annual 3-on-3 Ball Hockey Tournament. Over the past four years, they have raised $50,000, which will be used to support education and awareness of sudden cardiac death in young adults and assist medical research. In the meantime, the Corrances have this advice: “Don’t assume that your athletic child has a healthy heart.”
Read more information on Inherited Rhythm Disorders (IRDs).