Dionne February the month of love oo la la! It’s appropriately American Heart Month, a month highlighting the importance of focusing on your cardiovascular health. Today, Maleeha and I are really lucky to have not one, but two experts on all matters of the heart joining us. Now it’s not Ruth and Esther Perel. That’s a different kind of podcast. We have two cardiologist or heart doctors in the studio today. My friends Dr. Oluseyi Princewill and Dr. Ike Okwuosa.

Maleeha  Wow, Dionne, we are really doing some big things here. Not one guest, but two. It’s really exciting. Yes, we are. In this month dedicated to hearts and love. I feel like we are gathered here today to join two anesthesiologist and two cardiologists in a perfect union, which for us, means a discussion of heart health. There’s so much we can talk about today. But on this episode, we’re going to take a deeper look into the recent and very shocking incident involving an NFL player Damar Hamlin, and then discuss some key takeaways from that event as it relates to sudden cardiac arrest and heart disease in our own loved ones. So let’s get into it.

INTRO

Seyi   It’s so good to be here. And I’m really happy to be a guest and of course work together again with you Dionne.

Dionne  Me too. So excited Seyi.

Ike  Yeah, it’s my pleasure as well. And it’s nice to be able to collaborate with Seyi on this episode. Feels like all times.

Seyi  Yes. Love it.

Dionne  Yay. So wait, we have to introduce you properly first.

Maleeha  Yes, we do. We do.

Dionne  We have with us Dr. Oluseyi Princewill. She’s a cardiologist heart doctor practicing in the DC area with MedStar Health cardiology associates. Seyi treats a full spectrum of cardiac disorders with a primary focus on the prevention of cardiovascular diseases, women’s health and heart failure.

Maleeha  We also have Dr. Ike Okwuosa, who has advanced heart failure and transplant cardiologist at Northwestern University and the assistant dean of medical education. Thank you for joining us today as guests and as friends I’m curious Dionne, how did you guys meet? Was there like a meet cute? Do you even know what that is?

Dionne  Girl, you come up with these crazy phrases. I never know what you’re talking about.

Maleeha  I didn’t come up with that. That’s like from rom com. You know, like a good story of how you guys met? Well, there is there is a cute story

Dionne . Well, Shane, I went to the same medical school. I was the annoying first year bombarding her with questions and she was the star fourth year student. I just had to know her. I really just did and she was gracious enough to take me under her wings. So that’s that.

Maleeha  Oh, that’s so basically you were pursuing her?

Dionne  Yeah, basically, I sure was. I saw her from the cross room. So I had to I had to meet her.

Seyi  It was love at first sight love at first sight. I love it. Thank you Seyi.

Dionne  Then Seyi and Ike both trained at Johns Hopkins for the cardiology fellowship. Naturally, if Seyi liked him, I was gonna like them too. So I adopted him as my big brother, and good friend as well. And since he lives in Chicago, we hang out quite often.

Maleeha  Okay, Okay, nice. I’m not jealous. Clearly, you met them before me. But you know, it’s all six degrees of separation.

Dionne  Exactly.

Maleeha  Okay, Dionne. Let’s hit the brain trust up and get some answers from these experts we have with us. So let’s start with the current events. I think it is so shocking when we see a young healthy athlete like NFL player Damar Hamlin suffer sudden cardiac arrest on the field after a tackle. We were just also stunned as we watched him literally collapse. He’s only 24 years old, and you know, like presumably in peak physical condition. So what really happened?

Ike  So short answer without access to his entire medical record, you know, we don’t actually know, but it’s highly speculated that he suffered from a condition known as commotio cordis.

Dionne  Now that’s a fancy sounding medical term. Break down what commotio cordis is.

Seyi  Ok, let me get this Ike. Commotio cordis is a phenomenon in which a sudden blunt impact to the chess causes sudden death. Baseball’s the most common sport in which commotio occurs. Other common sports include lacrosse, hockey, and softball. But it can occur in other contexts, sports due to a hit from elbows, fist and helmets. Also, outside the world of sports commotio has been reported in collisions where there has been a hard impact to the chest, like a steering wheel during a car accident.

Dionne  Okay, so this could really happen to anyone with a completely healthy heart, a particularly blunt force to the chest wall because of sudden cardiac arrest. This is good to know.

Ike  Yeah, so there are several causes of a cardiac arrest. And let’s differentiate between a cardiac arrest and a heart attack because they’re not the same thing. So a cardiac arrest is when the heart stops. And this can be from a number of causes, whereas a heart attack occurs when the arteries of supply of the heart with blood become clogged or blocked. So this can this also can essentially can lead to a cardiac arrest. Other causes could be related to weakness in the heart muscle and conditions like heart failure, or genetic causes that can make someone at risk for having an irregular heartbeat.

Dionne  That’s why family history is so important.

Ike  Exactly. Also, Damar Hamlin is not the only athlete who has experienced sudden cardiac arrest. Now, you know, we’re gonna go back in time. And back to the 90s Hank Gathers one of the top college basketball players at his time, he died due to an abnormal heartbeat and the technical term, you know, the $60,000 words that we all paid for. He had exercise induced ventricular tachycardia. And this happened on a court. Another player, Reggie Lewis, this was a Boston Celtic and he died during offseason practice. You know, the reason for his death is not clear. He had a prior episode during the playoff game, they took him out of the out of the game. He got checked out in Boston, and he was told that he had a heart condition. But after a second opinion, it was thought that he just passed out. You know, if we fast forward to modern times, a professional soccer player by the name of Christian Erikson, he also collapsed on a field but survived because he had received immediate CPR. And he will also was essentially different related on the field. And it’s playing currently after getting into implantable defibrillator, which we can talk about a little bit more later.

Dionne  Great history lesson Ike sports history.

Maleeha  That was really informative. I actually remember watching Christian Eriksen fall on the field and that was really scary, very similar to Damar Hamlin, how sudden it was, but to be clear, those athletes you mentioned didn’t have commotio cordis. There was no blunt trauma. They seem to have other, you know, hidden heart problems that cause the sudden cardiac arrest.

Seyi  Yes, one of the causes of cardiac arrest in athletes is an enlarged or thickened heart called hypertrophic cardiomyopathy. This is an inherited condition that can be deadly under rigorous exercise stress. Another cause is an irregular heartbeat, also known as a cardiac arrhythmia. I think I mentioned exercise induced ventricular tachycardia, a lot of syllables. But yes, an example of a cardiac arrhythmia.

Dionne  So to reiterate, cardiac arrest when the heart stops pumping blood to our vital organs can be a result of commotio cordis, like in Damar Hamlin’s particular case, we think it’s the direct impact to the heart, almost like he was stunned, or the person could have an underlying heart defect that they may not be aware of, or they may be aware of depends.

Seyi  Exactly, Dionne. Like Ike said earlier, we can never be sure what happened with Damar. But commotio cordis courses is definitely on the differential, or list of possibilities.

Maleeha  Okay. I mean, it was so surreal to watch Damar Hamlin collapse.

Dionne  It’s like watching a gladiator fall, right?

Maleeha  Yeah. And as you mentioned earlier, we know this happens to athletes in many other sports.

Dionne  Wow. And I always thought football was the scariest sport like I was definitely like, my kids aren’t doing this but yeah. After your breakdown I maybe my kids will just do music lessons. Choir Chess club. All right.

Maleeha  Look, as with football, I’m always thinking of head injury repeat head injuries. So now Right? Yeah. All right. So you know, I’ve steered my kids away from football, they do play soccer though. And you know, as a parent with young kids who play sports, it’s kind of scary thinking that this could happen to my child, is it common for kids to collapse like that? Especially if they’re otherwise young, healthy? And if they do why, why would that be?

Ike  So you know, the short answer is anything is possible. In a condition like commotio c is rare. Let’s remember, the average population is youth in early teens. And several factors can contribute to this. We don’t fully understand all aspects. But you know, research is ongoing.

Maleeha  Okay. So early teens, that’s basically high schoolers. And that is kind of the age when you see that age group playing very competitively at a very high intensity level if they’re at school, like playing varsity or club, club teams. Right.

Ike  So a more common condition that has been associated with cardiac arrest and young athletes, and Seyi mentioned this a bit earlier, is hypertrophic cardiomyopathy. So in this condition, it’s hereditary, meaning that it’s passed down from mother to son, father to daughter, you know, passed on by your genes, and results a significant thickening of the heart muscle. And in severe cases, this can lead to a blockage of blood leaving the heart that supplies the vital organs, including the heart itself. Now, the second most common cause of cardiac arrest in young athletes is what we term an anomalous coronary artery, again, another one of those $60,000 words that we paid for it, but we’re giving it to the audience for free. So this fancy medical term, this fancy medical term means that the coronary artery isn’t where it’s supposed to be. So let’s remember, the heart is responsible for pumping blood to the whole body, but also needs to pump blood to itself. So the coronary arteries are the vessels that supply blood to the heart so that it can function. So when there’s a blockage in these arteries, someone can have a heart attack, we all have to coordinate arteries are right and a left and they originate from different sites. And sometimes people are born with arteries that are, are pretty much plugged in to the wrong places. And this abnormality is what we call an anomalous coronary. So this condition can lead to the heart arresting. Other less common causes include inflammation of the heart, such as myocarditis, and heart valve disease, and also a dissection or rupture of this big vessel called the aorta.

Seyi  So we definitely would like to emphasize these are not common. But as I’ve said, anything can happen. Maleeha, I know you mentioned having children earlier. And I think it’s important for all of us parents to pay close attention to our children, and how they feel while playing sports. Although dehydration is likely the most common reason young children may pass out, don’t hesitate to call your child’s pediatrician. If you don’t think dehydration is the cause. You can also ask the pediatrician for a referral to a cardiologist for further testing. It’s also critical to know your family history. had any uncles, aunts, cousins or other relatives died suddenly at a young age, who has heart disease in the family. This information is important to know and can give your doctor clues about working your child up for underlying heart conditions.

Dionne  That is great.

Maleeha  Okay. That’s a really great tip. Yes, absolutely. Yeah. Especially because I’m here in Arizona, and it’s like, hot, and everybody just assumes people fall over from dehydration because they literally practice here year round because of the weather. And you do really see a lot of kids come into the emergency room, sometimes just needing fluids and being worked up for you know, exhaustion overheat. You could be something else going on though.

Dionne  Yep, absolutely. And you know, Maleeha this, this next question is very relevant to you because your kids are like in high intensity soccer, but it’s relevant to all parents with children in sports. Now, are there ways to screen for cardiovascular disease and athletes? I know most sports teams, even in middle and high school require history and physical from their doctor as a waiver. But typically, these kids don’t have any symptoms, which makes early detection tricky.

Ike  So you know, when I see a patient for a health screening, you know, I typically discuss key aspects of their history, especially the family history, you know, have they been experiencing fatigue? That’s out of the ordinary history of dizziness, shortness of breath, any chest pain? Now, if we delve into the family history, has there been a premature episode of death, primarily in the form of sudden cardiac death? Is there a family history of heart disease, especially in a younger population, and we define younger people lesion is those less than 50. Then we also discuss key aspects of the physical examination, right? So you know, we do a typical head to toe in cardiovascular medicine, we know we listen to the heart and lungs. But if we hear a murmur, and a murmur is essentially an abnormal sound that the blood is making a ghost through the valves, if that is picked up, this is a sign that we need to do more testing.

Seyi  Good points. I know that one of the big questions that came up after the Hamlin incident was why didn’t he get testing done before this happened? And to my knowledge, it’s not really required for young athletes to be screened by more advanced imaging testing like EKGs or echocardiograms, which are ultrasounds of the heart.

Dionne  That’s a good point.

Maleeha  Yeah. So, okay, so back to Damar Hamlin, you know, it took days of anxious waiting for any update on how he was doing. I remember initially, he was obviously in critical condition, he required a breathing tube, he was in the ICU, we were all really worried about whether he would survive. And, you know, even if he survived, to what extent would he be neurologically intact? Would he wake up? Would he be able to talk? Would he be able to walk, but it seemed, you know, thankfully, within days, his condition improved drastically. He went from hand gestures, to writing, to talking, to being completely with it as if nothing happened at all. It just seemed like a real miracle.

Dionne  Yeah, but something did happen. We all saw it. He suffered a cardiac arrest. So why was his recovery so quick and miraculous?

Seyi  Yeah, Dionne, this is the importance of timely CPR. Yes, time is brain. It’s generally believed that if CPR is not performed within two to three minutes of a cardiac arrest, brain injury can occur and becomes worse, the longer it takes for flow to be restored back to the brain. After about nine minutes, brain damage is considered likely, the chance of surviving a cardiac arrest after about 10 minutes is low. Given how well Hamlin appears to be doing, it seems as if he did not lose any brain or physical function due to his cardiac arrest.

Dionne  Yeah, he’s like back to normal. I just saw him speak yesterday.

Maleeha  Oh, yeah. I did see that, too. He had it. He was on stage with, like the medical team that took care of him.

Dionne  They definitely yeah, he had a whole speech and that’s amazing.

Seyi  The NFL honors?

Dionne  Yes. So you’re absolutely right about timely CPR Seyi.

Maleeha  Yeah, being prepared is critical. And people should learn the basics of CPR.

Seyi  Absolutely. Whether it’s an athlete on the field or your grandparent at home, if you witnessed someone fall, you can help.

Maleeha  Okay, so let’s take a quick minute to pause and just review the basic steps of CPR if you see someone fall.

Ike  Sure. And you know, I’ll take this one. You know, the basics of CPR include First things first, call 911. Then also call for help. You know, if there’s bystanders to assist you assess your surroundings to make sure it’s safe to approach the person and figure out if the person is conscious or unconscious, feel for a pulse. And if there’s no pulse, then you start chest compressions right away. If you are not alone, you know someone should get the defibrillator as soon as possible to be ready to shock if you can. But if you are alone, just continue doing chest compressions because quality chest compressions is the key and can also save a life.

Dionne  Good point. Good. Good point. So what tools do you think the average person needs at home or in their car that can help them manage this type of scenario.

Seyi  Really, a cell phone or any phone just so you’d be able to call for help. Also, your hands, hands-only CPR really does save lives. Get trained in CPR, please.

Dionne  Facts, facts, facts! Absolutely.

Seyi  Now, all public places should have an AED, which is an automated external defibrillator. It’s a pretty sophisticated medical device that can analyze a heart rhythm and deliver an electrical shock that can reset the heart. You can see them in many public places, including airports, high schools, and stadiums.

Dionne  Very true. An AED can really save lives if the heart has a funky, fast rhythm that it can be shocked out of. It’s like hitting the reset button. It’s not like TV guys, a defibrillator cannot bring someone back from the dead. You know how you see the flatline on the screen? Shocking it won’t work.

Maleeha  I get so mad at those scenes and the movies are at home. I’m the one who’s like heckling the screen, you see that flatline? We call it asystole. And everybody’s like, shock. Oh, clear, you know, and I’m like, That doesn’t work. That’s chest compressions. Please stop. So yeah, you know, the AEDs though, are amazing. They’re really easy to use. They give you instructions for the lay person how to use them how to place them, and they tell you what rhythm is shockable and what is not.

Dionne  Absolutely, they should be everywhere. They really should.

Maleeha  They should! Okay, so I’m no athlete. I you know, what about the average person like myself. I am far from Damar. Okay. The most I do right now is walk on the treadmill. I am currently doing that whole. Have you heard of like, yeah, like this? 12/3/30 It’s like a routine right now on Instagram. But I’ve been trying it, it is just basically walking really slow on an incline. What factors increase my risk of suffering a cardiac arrest?

Seyi  So definitely tobacco use. I can’t say this enough. If you smoke cigarettes, stop.

Maleeha  Okay. Not guilty. Okay, good.

Seyi  Now, what most people are guilty of is eating lots of processed foods. Yes, that’s Chic Fillet, Chipotle, that Lean Cuisine in the frozen section at the grocery store.

Maleeha  Oh, that’s tricky, Lean Cuisine,

Dionne  But not so lean.

Maleeha  I’m guilty getting better. Yeah.

Seyi  And of course, stress, we all experience it. But stress can definitely be a risk factor for heart disease.

Maleeha  That’s, that’s a that’s a hard one to manage a little trickier.

Dionne  Yeah, I think we’re all guilty of the stress factor at this table here. So anyways, we’ll try to manage the other factors. But anyhow, how can we reduce the risk of serious heart conditions?

Seyi  Exercise, exercise, exercise, everyone’s favorite word. But it’s also important to eat and healthy, balanced diet. Yes, favorite.

Dionne  It should be my favorite. But it’s hard to stick to. It’s so hard. It’s so hard.

Seyi  I know. But if you can incorporate small changes into your daily routine, like taking the stairs instead of the elevator, or parking the car a little further away from the entrance, they can all add up. I do do those things. I do do those things. I’m gonna give myself a pat on the back for that.

Maleeha  See Dionne, I feel like yeah, we need to get to a Fitbit or something. Because that like, counts the steps for the whole day, you’re trying to hit 10,000. And I can always tell I don’t know if you can, I can always tell the person who has a Fitbit because they are like every step counts, they are walking, they are marching in place. They are so deliberate. And I used to have one actually, but I would be stuck in these long cases in the OR and it would, it would alert me that I had been so inactive and I just I felt like a failure. So I took it off.

Dionne  Yeah, it was affecting my mentally demoralizing

Maleeha  Exactly. Like I’m so far from 10,000 steps today. So let’s just take this off.

Dionne  Besides diet and exercise, you know, everyone is all about supplements. They seem to take one for everything. Fish oil, Omega three capsules, garlic. There’s so many to choose from. Are there any at all that you recommend for patients?

Seyi  I personally do not. I don’t know if it feels differently, but recommendations for supplements really do depend on your current health status and existing conditions. I’m not sure there are any supplements I would recommend to everyone.

Ike  And I agree with Seyi on that matter.

Maleeha  Okay, did you hear that guys? Don’t just grab what your friend is taking because they say it’s working for them. Don’t waste your money taking pills. You just don’t need to talk to your doctor first. Okay, so let’s recap and break it down because we learned a lot today. We covered a lot of material in a short amount of time. But number one, we learned that Damar Hamlin likely suffered commotio cordis ,a rare condition related to sudden contact to the chest. It can occur in any contact sport, not just football.

Dionne  Number two, the most common cause of cardiac arrest and athletes is an inherited condition called hypertrophic cardiomyopathy, where the heart muscles really thicken. This is why knowing your family history is so important.

Maleeha  Number three, make sure you have your children screened before they play sports and pay attention to symptoms like passing out dizziness and fatigue. Again, make note of that family history especially if there’s a history of sudden cardiac death.

Dionne  Number four, exercise healthy diet and stress reduction and smoking cessation decrease your risk of heart disease and cardio arrest.

Maleeha  Number five discuss with your doctor before taking a supplement advertised for heart health. Many of the touted benefits are overstated.

Dionne  Number six, learn CPR, it saves lives and brain cells, especially when done in a timely manner.

Maleeha  Number seven, check out your local high school gym or sports venue and make sure they have an AED, a defibrillator on site. This is not just important for athletes, but also the spectators you never know who may need it.

Dionne  Seyi and Ike, thank you for sharing your expertise with us. We hope that a lot of broken hearts will be fixed by listening to this episode. Get it balanced and today. Broken Hearts. Anyone? All right. Wow. Wow. Anyways, but on a serious note, this is definitely an episode to bookmark. If you’re listening as a sports fan or a parent, we hope that it helped you understand the causes of sudden cardiac arrest in any sport, and the importance of a thorough health screening.

Maleeha  Absolutely Dionne, being heart healthy is vital, pun intended, at every age. Even if you’re not a competitive athlete, this conversation has been a great reminder to exercise every little step matters. Eat well follow up with your doctor, especially if you have a family history of heart problems, and that it doesn’t take that long to brush up on some CPR skills. For more IVY drip tips, or to listen to this episode, or any past episode, we have done, head to our website at theIVYdrip.co. There you will find more information about our guests today. And email us with your stories, comments and questions at info at theIVYdrip.co.

Dionne  We love to hear from you all. If you have a good tip, we would love to share that on our next episode. Don’t forget to subscribe to our podcast. You can find it on all streaming platforms and spread the love. As we start out on this podcast. We need your support by sharing this episode with your friends and leaving us a review. Now for the tip of the day. Seyi and Ike would you do with the honor?

Ike  Okay, so I’ll go first. My tip of the day is an apple a day should not keep the doctor away. So see your doctor regularly. Know your family history. This could be instrumental to your doctor making a proper diagnosis and also share the podcast such as The IVY Drip.

Maleeha  Thanks, great tip.

Seyi  Great tips Ike. My last thought if all you have time to do is walk 10 minutes a day, do it. It can lead to a longer life. If almost all of us started walking for an extra 10 minutes a day. We could collectively prevent more than 111,000 deaths every year.

Dionne  Over 100,000 deaths a year. That is a huge number. That’s like over 300 deaths a day. That’s a great tip Seyi.

Seyi  Yes and that’s why I said exercise is my favorite word.

Dionne Okay, it’s becoming mine too.