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NHL Ice Hockey player retires after screening reveals Long QT syndrome

Filed under: News/Events - Posted on Saturday, September 30th, 2006 @ 2:30 am

By Rick Sadowski, Rocky Mountain News
September 30, 2006

CENTENNIAL – Few in the NHL played with as much heart as Steve Konowalchuk, making the reason he is giving up the game at age 33 so painfully ironic.
Diagnosed with long QT syndrome, a rare hereditary disorder of the heart’s electrical system, the Avalanche forward Friday announced his retirement.
The condition was detected during an electrocardiogram administered Sept. 14 as part of the routine physicals that all players are given before training camp.
Konowalchuk underwent additional tests at the University of Rochester Cardiac Center, a research center for the syndrome, after which he was strongly advised by doctors to retire.
Calling the past few weeks “very stressful,” Konowalchuk said he had little choice but to hang up his skates after 13 NHL seasons because of the risk involved with playing such an intense sport, especially when he has a wife and two young children.
“I certainly don’t want to go out and play a hockey game and have my wife or my children wondering what the risk is, whether it’s 1 percent, 10 percent or half a percent,” he said during a news conference at the South Suburban Family Sports Center.
Only a few feet away, as Kono- walchuk spoke, the Avalanche practiced in preparation for its preseason finale tonight, against the Los Angeles Kings at the Pepsi Center. The regular season begins next week.
“Watching hockey is going to be hard,” he said. “Two weeks ago I was ready for training camp. I was ready to put a season together and continue my career.”
It was the third low blow in less than two years for Konowalchuk, who missed the final 61 games last season because of a wrist injury that required surgery. He and every other NHL player lost out on the entire 2004-05 campaign, canceled by commissioner Gary Bettman because of a labor dispute.
“As much as I feel I’ve been gypped out of a couple of years, I was still able to put a fairly long career together and accomplished some goals, proving that I can be a player, so I won’t be chasing those demons my whole life,” said the Salt Lake City-born Konowalchuk, who totaled 171 goals and 225 assists in 790 NHL games and played for the U.S. in two World Cups and two World Championships.
Dr. Steve Friedrich, the Avalanche’s cardiologist, said he believes the risk of playing with long QT syndrome is “relatively low,” but that it was necessary for Konowalchuk to be evaluated by physicians who specialize in the disorder.
“Their impression,” Friedrich said, “was that he still is at some low level of risk, and that’s a risk he shouldn’t take.”
Avalanche general manager Francois Giguere said Konowalchuk would be paid his full salary of $1.9 million, and he has been offered an as yet undetermined position in the organization.
“One thing that was clear, every doctor that saw Steve said he shouldn’t be playing,” Giguere said. “I told him, ‘If I was your older brother, there’s no doubt in my mind what the decision has to be.’ ”
Friedrich said the disorder is one that doctors screen for when judging whether someone should be playing sports.
“It’s something that you’re born with, but it doesn’t always show up (on an EKG),” he said. “In Steve’s case, he’s been looked at every year for a long period of time and it has not shown up previously. It clearly did show up this time, and the fact that it runs in his family was a concern.”
Konowalchuk can be treated with medication, and he is expected to be able to live a full, normal life as long as he doesn’t undertake any activity that’s deemed too strenuous.
“This is an absolute surprise,” he said of his medical condition. “I had been skating and training as usual and getting in shape for camp. I’ve had EKG’s every year of my career and they’ve all been very good. For whatever reason, it turned up now.”
Konowalchuk, who said another family member has the condition, was concerned he might have passed it on to his children – ages 8 and 6 – because it is hereditary. He was greatly relieved when both were tested and found to be free of it.
“The first thought was my children,” he said. “That was the biggest stress. At that point, I didn’t worry about hockey. Once we dealt with that – everything seems to be very good there – the next thing I know, wow, I’m dealing with not playing hockey.”
Athletes in several sports have been diagnosed with heart problems over the years, the most serious in hockey involving Detroit Red Wings defenseman Jiri Fischer, who last year collapsed on the bench during a game and had to be resuscitated using CPR and a defibrillator.
Fischer, 25, recovered from the incident but hasn’t played since.
Konowalchuk remembers it all too well, having seen it unfold on television.
“You felt like throwing up,” he said. “You think that could be anyone of us. Here I am later being told I’m putting myself at risk to play. As much as you want to play, it’s pretty easy to put it in perspective. It’s just a game, and there’s a heck of a lot more than playing a game.”
Avalanche coach Joel Quenne- ville and his players feel badly for Konowalchuk, who has been an energy-driven forward and a team leader. He played parts of 12 seasons with the Washington Capitals and was their captain when the Avalanche acquired him in October 2003 for Bates Battaglia and prospect Jonas Johansson.
“You know how badly he wants to play,” Avalanche captain Joe Sakic said. “These last couple years, with the lockout, and he was out (most) of last year . . . he worked so hard to get back. It’s unfortunate news.
“But it’s better to find it now. Safety comes first, and your family comes first. Obviously, it’s a decision you support and respect.”
MAY SURGERY: Another Avalanche forward, Brad May, underwent reconstructive shoulder surgery and will be sidelined four to six months. He was injured in a fight with Detroit’s Darryl Bootland in a preseason game Monday.
Heart matters
Long QT syndrome, the condition that forced Avalanche forward Steve Konowalchuk to retire at age 33, “is a genetic disease involving electrical conduction which can lead to irregular heart rhythms,” team cardiologist Dr. Steve Friedrich said.
• It is a rare disorder, Friedrich said, affecting one in 10,000 people, but the odds increase to one in two persons in a family when one member has the condition.
• According to the American Medical Association, the heart, when it contracts, emits an electrical signal that can be recorded on an electrocardiogram (EKG). It produces a characteristic wave form designated by letters – P, Q, R, S and T. The QT interval represents the time for electrical activation and inactivation of the ventricles, the heart’s lower chambers.
• The time it takes for the QT interval to occur can be measured in fractions of a second. If it takes longer than normal, it’s called a prolonged QT interval.
People with the disorder are susceptible to an abnormally rapid heartbeat (arrhythmia), meaning the heart muscle can’t contract effectively and the normal volume of blood is reduced to the body and to the brain. If the brain is starved of oxygen, the person faints within seconds.
• If the heart can’t regain its normal rhythm, it can go into spasms that lead to a deadly arrhythmia called ventricular fibrillation. Without immediate emergency treatment, death follows within minutes.
• People with this condition may show prolongation of the QT interval during physical exercise or intense emotion, which is why Konowalchuk shouldn’t participate in a high-speed sport like hockey.
• Treatments for the condition include medication, though sometimes a surgical procedure is needed.
Friedrich said he expects Konowalchuk “to live a very normal life with very minimal restrictions in activities.”
He just can’t play hockey.

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