NBA: What does your heart say?
League will be keeping close eye on cardiac issues that can arise with virus
The hardest-working muscle in an NBA player’s body will get extra attention if there is a COVID-19 positive test.
NBA officials and teams will play close attention to a player’s heart. Before a player returns from a positive test, he must satisfy specific requirements: isolation period, absence of symptoms, two negative tests at least 24 hours apart and cardiac screening. Why cardiac screening?
“The concern is really an extension of what all of the pro teams are doing already, and that’s protecting their athletes from cardiac events more so than they have in the last five years or so,” cardiologist Matthew Martinez told USA Today. “That extension now is with COVID-19 because initial reports said this had a high prevalence [among] hospitalized patients. Those were sicker patients, and about 30% were reported to have cardiac involvement. That was what really tipped things off.”
In a study funded by the British Heart Foundation and published in the European Heart Journal last week, 55% of 1,216 patients from 69 countries “showed abnormal changes to the way the heart was pumping, with around one in seven showing evidence of severe dysfunction.”
Myocarditis, which is inflammation of the heart muscle, and clotting are two significant issues Martinez has seen in patients. Both can lead to fatal heart conditions, said Martinez, who is the consulting cardiologist for the National Basketball Players Association and reviewed the NBA’s protocol with the league’s 13-person Cardiac Advisory Committee. Martinez is also the director of sports cardiology and co-director of the Chanin T. Mast Hypertrophic Cardiomyopathy Center at New Jersey’s Morristown Medical Center and lead cardiologist for Major League Soccer.
While much remains unknown and as researchers are learning more about COVID-19, the NBA ensured cardiac screening is part of its extensive health and safety protocols. An abundance of caution rules the day, and heart injuries from COVID-19 are something other sports will need to watch, too.
The screening is three-pronged: troponin testing, which can detect heart injury in the blood; an electrocardiogram, which measures heart function; and an echocardiogram, which generates images of the heart to assess left ventricular function.
“All three have to be done, and it’s really a comprehensive way to screen for active inflammation or damage to the muscle as well as perhaps a prior episode,” Martinez said.
The cardiac-screening requirements for players are based on the ‘‘American College of Cardiology’s Sports & Exercise Cardiology Council recommendation and are the result of ongoing review by consulting cardiologists for NBA teams, the NBA’s consulting cardiologists at Columbia University and the Players Association’s consulting cardiologist. They reflect a current consensus approach, recognizing that the complete clinical picture of COVID-19 and potential effects on cardiac health, including myocarditis in particular, are not yet fully understood and might be modified in the future to reflect new information.”
Even players who have not tested positive but have had symptoms associated with COVID-19 within the last three months must undergo an evaluation.