WEBVTT - Sudden Cardiac Arrests in Young Athletes 0:00:05.160 --> 0:00:05.680 Hi everyone. 0:00:05.720 --> 0:00:08.160 It's me James today and I'm joined by Glen Pyle, 0:00:08.200 --> 0:00:11.240 who's a professor of molecular cardiology and a member of 0:00:11.240 --> 0:00:14.040 the IMPART Network at Dalhousie Medicine. 0:00:14.400 --> 0:00:16.040 Glenn, thank you so much for joining us. 0:00:16.360 --> 0:00:18.080 Can you is there is there anything I missed out 0:00:18.079 --> 0:00:19.560 first of all in your bio there that might be 0:00:19.640 --> 0:00:20.400 relevant for people. 0:00:20.600 --> 0:00:22.840 No, I think that's a short and sweet I don't 0:00:22.840 --> 0:00:24.040 need all the details for. 0:00:23.960 --> 0:00:24.640 Sure, Thank you. 0:00:24.880 --> 0:00:25.079 Yeah. 0:00:25.120 --> 0:00:28.280 So, what we're here to talk about today is these 0:00:28.640 --> 0:00:33.040 sudden the phenomenal I suppose of sudden cardiac arrest specifically 0:00:33.200 --> 0:00:37.520 like in young people and young athletes, because as many 0:00:37.560 --> 0:00:40.960 of you will have been aware, this has been increasingly 0:00:41.280 --> 0:00:45.519 an area in which anti vaxxers and conspiracy theorists have 0:00:45.640 --> 0:00:48.720 been trying to leverage what is an unfortunate but not 0:00:49.080 --> 0:00:54.080 unprecedented cardiac arrest, like in this case, most recently Bronnie James, 0:00:54.080 --> 0:00:56.120 but it has happened before in the number of sports, 0:00:56.280 --> 0:00:58.240 and they've been trying to leverage us as of quote 0:00:58.400 --> 0:01:01.400 unquote like prove for evidence that the vaccines are killing 0:01:01.400 --> 0:01:05.320 otherwise healthy young people, which is nonsense. And I can 0:01:05.360 --> 0:01:06.880 tell you it's nonsense. But someone who can tell you 0:01:06.920 --> 0:01:10.400 from much more informed perspective is Glenn. So Glenn, can 0:01:10.480 --> 0:01:13.480 we start out by maybe talking about like how common 0:01:13.760 --> 0:01:17.520 this sudden cardiac arrest in young athletes is and what 0:01:17.600 --> 0:01:20.679 we might what hypothetes we might have to what caused it. 0:01:22.200 --> 0:01:23.759 Well, I mean, first of all, we look more broadly, 0:01:23.800 --> 0:01:27.920 it's very common. I'm from Canada and we have about 0:01:27.959 --> 0:01:33.360 thirty five thousand of these every year within young athletes. 0:01:34.160 --> 0:01:37.040 The data out of the US says that about two 0:01:37.120 --> 0:01:42.199 thousand die every year from sudden cardiac arrest, and two 0:01:42.280 --> 0:01:46.120 thirds of these young people do so during some sort 0:01:46.120 --> 0:01:50.400 of exercise or sporting event. So in the grand scheme 0:01:50.440 --> 0:01:52.400 of things, when you have a country of several hundred 0:01:52.440 --> 0:01:56.160 million people, a thousand or so that's like that is 0:01:56.880 --> 0:01:59.440 but proportion relatively small. But we've known about this for 0:01:59.480 --> 0:02:01.880 a long time and these numbers actually really haven't changed 0:02:02.000 --> 0:02:03.840 very much in decades. 0:02:04.440 --> 0:02:08.520 Okay, So yeah, there's obviously been a particularly increase due 0:02:08.560 --> 0:02:14.079 to COVID vaccinations, because they're unrelated. I wonder actually it's evidence. 0:02:14.280 --> 0:02:16.760 I think I've read some stuff that having COVID or 0:02:16.800 --> 0:02:20.560 having had COVID multiple times might increase your risk for 0:02:21.000 --> 0:02:21.760 cardiac arrest. 0:02:21.840 --> 0:02:23.799 Is that true? 0:02:23.919 --> 0:02:27.080 Yeah, so broadly, So they haven't looked specifically at cardiac 0:02:27.160 --> 0:02:30.600 arrests because cardiac arrests typically is in a lot of 0:02:30.600 --> 0:02:33.160 times the end result of a number of different conditions 0:02:33.160 --> 0:02:38.639 of cardiac arrhythmias are known to be increased. A patone 0:02:38.680 --> 0:02:41.679 study showed that. But I guess the year and a 0:02:41.720 --> 0:02:46.520 half ago by now, certainly early in the pandemic, one 0:02:46.560 --> 0:02:48.840 of the first signs we were seeing people who are 0:02:48.880 --> 0:02:54.320 being infected were having heart attacks, developing heart failure, these things, 0:02:54.600 --> 0:02:59.639 and in cardiac arrest the most common cause or cardiac 0:02:59.639 --> 0:03:03.480 are with Yes, the tone study showed And every time 0:03:03.600 --> 0:03:06.160 I talk about this, I have to go back and 0:03:06.200 --> 0:03:12.600 look because the increase was several hundredfold after COVID, and 0:03:12.720 --> 0:03:16.320 so I have never really seen anything like that before. 0:03:16.480 --> 0:03:20.760 So arrhythmias are relatively common in terms in the world 0:03:20.919 --> 0:03:25.320 of cardiovascular disease, and the fact that COVID the infection, 0:03:25.840 --> 0:03:30.240 actually increases it. But the vaccines do not means that 0:03:30.320 --> 0:03:33.120 the risk for some cardiac death really would be highest 0:03:33.120 --> 0:03:36.560 amongst those who are infected, not those who get vaccines. 0:03:36.880 --> 0:03:41.320 Okay, do you know offhand if like when we have 0:03:41.440 --> 0:03:43.880 that maybe this was too early in the pandemic to 0:03:43.920 --> 0:03:47.360 tell like that that risk that comes with having COVID 0:03:47.400 --> 0:03:51.000 right for having rhythmia afterwards, is that risk mitigated by 0:03:51.120 --> 0:03:54.320 if you're vaccinated and then you get COVID. 0:03:54.800 --> 0:03:59.680 So yes, there's been some more recent studies because obviously 0:03:59.720 --> 0:04:02.760 early in the pandemic, when we didn't have the vaccines, 0:04:02.840 --> 0:04:06.240 we couldn't answer that. And then early after vaccines were 0:04:06.240 --> 0:04:08.840 looking at things like infections, and some of these cardiac 0:04:08.920 --> 0:04:13.720 issues may not arise until even after the infection is clear. 0:04:13.800 --> 0:04:16.000 So we see that in people with long COVID, for example, 0:04:16.120 --> 0:04:21.240 krdiac issues are most common. And so we've seen in 0:04:21.760 --> 0:04:26.560 some recent studies that people who are didn't even what 0:04:26.600 --> 0:04:30.760 they described as partially vaccinated, so one or two doses, 0:04:31.080 --> 0:04:34.120 had a reduced risk of what we call MACE, which 0:04:34.160 --> 0:04:37.640 is a major adverse cardiovascular event. And so that's an 0:04:37.640 --> 0:04:41.040 all encompassing term, which would be things like stroke, heart attack, 0:04:41.640 --> 0:04:44.359 you know, things things like that, those major cardiac events. 0:04:44.880 --> 0:04:49.720 That's data has come out earlier this year, within the 0:04:49.800 --> 0:04:51.120 last year, a couple of studies. 0:04:51.360 --> 0:04:56.400 Okay, so circling back to those cardiac arrests and I 0:04:56.400 --> 0:04:59.520 guess wrote more broadly at cardiac issues in young people 0:04:59.560 --> 0:05:03.760 and fitting young athletes. It's something I'm familiar with with 0:05:04.360 --> 0:05:07.760 a background in cycling. Like I've known people die of 0:05:07.800 --> 0:05:11.800 cardiac arrests who otherwise extremely fit. No, I wouldn't necessarily 0:05:11.880 --> 0:05:14.359 say like sometimes being fit and being healthy are not 0:05:14.360 --> 0:05:18.360 the same thing. Certainly the very like point to end 0:05:18.360 --> 0:05:20.560 of indurance sport. I think the fittest people are not 0:05:20.600 --> 0:05:24.320 necessarily the healthiest, but very fit sometimes very healthy people 0:05:24.560 --> 0:05:29.800 have friends of mine have had these issues. Is in 0:05:29.839 --> 0:05:33.039 those cases we might not know? I don't know is 0:05:33.160 --> 0:05:38.080 being an athlete like increasing someone's chance of having those 0:05:38.120 --> 0:05:39.840 cardiac arrests or is it that they have some kind 0:05:39.880 --> 0:05:43.120 of pre existing condition that's just that's just been underlying 0:05:43.160 --> 0:05:43.599 for a while. 0:05:45.080 --> 0:05:48.240 Yeah, that's a good question. What we do know in 0:05:48.320 --> 0:05:52.159 this This is all data from pre COVID, so it's 0:05:52.200 --> 0:05:55.400 not something that's been impacted by the panamic or vaccines. 0:05:56.000 --> 0:06:00.360 We do know that the rate of sudden cardiac death 0:06:00.360 --> 0:06:02.880 and the general population is about one in one hundred thousand, 0:06:03.320 --> 0:06:05.839 and that in athletes, which is a very broad term, 0:06:05.839 --> 0:06:07.320 and we can get into that. How to we do 0:06:07.400 --> 0:06:10.440 find an athlete and things like that is anywhere from 0:06:10.480 --> 0:06:14.480 two to four times the rate that that's groups of 0:06:14.520 --> 0:06:19.800 athletes subsections are actually higher, so we know the radius 0:06:20.000 --> 0:06:25.440 higher in these athletes, typically these high performance athletes. You 0:06:25.440 --> 0:06:28.360 know why that is, It's an interesting question. It could 0:06:28.400 --> 0:06:34.160 be the training, for example, puts a stressor on them. 0:06:34.839 --> 0:06:37.680 So they may have a pre existing condition. They may 0:06:37.760 --> 0:06:41.880 have a cardiac orithm of like long QT syndrome or 0:06:41.920 --> 0:06:46.440 even something called hypertrophic cardiomopathy. Sometimes they know about it 0:06:47.000 --> 0:06:50.280 and sometimes they don't, and then the training on top 0:06:50.440 --> 0:06:53.200 is enough of a trigger. So one of the examples 0:06:53.200 --> 0:06:58.680 I use in my class is Anthony Evenlows, a soccer player. 0:06:58.760 --> 0:07:00.720 I believe it was in the Netherlands. He was playing. 0:07:01.000 --> 0:07:04.719 He had a known cardiovascular condition, so he had what's 0:07:04.720 --> 0:07:08.640 called it ICD or on planet cardiodefibrillator while he was playing, 0:07:09.000 --> 0:07:11.640 and he suffered some cardiac death on the on the field. 0:07:12.400 --> 0:07:15.120 There's actually video of it, and that shocked him back 0:07:15.160 --> 0:07:18.120 into rhythm. So you know, some of these people may 0:07:18.160 --> 0:07:21.640 not know and discover in the course of training, and 0:07:21.680 --> 0:07:25.560 some may know and opt to take that risk anyway, 0:07:25.680 --> 0:07:28.120 and then it's the training that or the competition that 0:07:28.160 --> 0:07:28.680 brings it out. 0:07:28.760 --> 0:07:30.040 Yeah, okay, yeah, yeah. 0:07:30.040 --> 0:07:33.720 I have a very good friend with ICD and it's 0:07:33.720 --> 0:07:36.920 certainly been at the end of a very difficult process 0:07:37.400 --> 0:07:39.680 for him to have that, and that involved lots of 0:07:39.680 --> 0:07:44.640 lifestyle changes. And so when we let's what exactly is 0:07:44.680 --> 0:07:46.880 an athlete in these studies, like, is that somebody goes 0:07:46.920 --> 0:07:48.720 to gym twice a week? Is it someone putting in 0:07:48.720 --> 0:07:50.520 twenty hours on the bike, like what? 0:07:52.280 --> 0:07:54.600 So, most of the studies that we're talking about, so 0:07:54.800 --> 0:07:57.400 I assume we're not talking about the people who are 0:07:58.320 --> 0:08:01.040 claiming that the vaccines are to athletes because they have 0:08:01.080 --> 0:08:04.480 a very different definition. I can talk about that most 0:08:04.520 --> 0:08:07.520 of these studies that we're dealing with, where we get 0:08:07.520 --> 0:08:10.120 these rates that are two to four times higher than 0:08:10.160 --> 0:08:14.280 the general population or what they refer to as competitive athletes. 0:08:15.000 --> 0:08:17.840 So for people in the US, these would be your 0:08:17.960 --> 0:08:22.080 NCAAA or college athletes. Some of them are professional athletes, 0:08:22.440 --> 0:08:24.600 you know, soccer players and the you know, the British 0:08:24.680 --> 0:08:27.240 League and things like that. So these are people who 0:08:27.360 --> 0:08:31.600 play at a at a competitive level. Oftentimes they're they're 0:08:31.640 --> 0:08:34.400 making a living. I mean, you can argue whether college 0:08:34.400 --> 0:08:36.320 athletes are making a living out of this, but there's 0:08:36.360 --> 0:08:40.040 there's some high level of competition in these athletes. That's 0:08:40.120 --> 0:08:42.960 generally the people that were that these studies are based on, 0:08:43.120 --> 0:08:45.240 not the guy who goes to the gym twice a 0:08:45.280 --> 0:08:46.360 week or something like that. 0:08:46.600 --> 0:08:48.360 Okay, yeah, yeah, so fairly elite. 0:08:48.480 --> 0:08:51.520 And what is it that you were saying that's different 0:08:51.520 --> 0:08:55.080 from the claims that these anti vax people or vaccine 0:08:55.080 --> 0:08:58.320 skeptics or whatever, you know, people who want to say 0:08:58.360 --> 0:09:01.200 that vaccines are getting people which isn't true. What sort 0:09:01.200 --> 0:09:03.720 of the definition that they're using or what's the claim 0:09:03.760 --> 0:09:04.400 that they're making. 0:09:04.440 --> 0:09:08.400 I guess, well, they really don't have a definition, is 0:09:08.440 --> 0:09:13.000 the problem. So they'll use the term athletes. And I 0:09:13.000 --> 0:09:16.040 think most people, you know, maybe maybe you don't see 0:09:16.040 --> 0:09:19.240 an athlete as necessarily being a college or professional level. 0:09:19.480 --> 0:09:22.520 It could be like a high school athlete who's competing 0:09:23.040 --> 0:09:24.839 you know, once or twice a week or whatever. And 0:09:24.920 --> 0:09:28.600 that's that's fair. But when you look at the lists 0:09:28.760 --> 0:09:31.560 that they have, I mean, I've talked about this recently 0:09:31.640 --> 0:09:34.800 and the Died Suddenly movie documentary, whatever you want to 0:09:34.840 --> 0:09:38.559 call it. The list of people that they have on there. 0:09:38.600 --> 0:09:43.120 For example, they have musicians, they have a Thai princess 0:09:43.160 --> 0:09:48.040 on the princess from Thailand on there, and they also 0:09:48.040 --> 0:09:51.280 have people who died of cancer, someone who got an 0:09:51.280 --> 0:09:55.640 eye injury. So I'm not really sure, first of all, 0:09:55.640 --> 0:09:58.800 what their definition of athlete is. I'm not sure what 0:09:58.880 --> 0:10:01.320 their definition of sudden cardiac death is. When you have 0:10:01.360 --> 0:10:05.040 people dying of cancer or suffering an eye injury like that, 0:10:05.080 --> 0:10:10.480 those are not related at all. There was an earlier list. 0:10:10.600 --> 0:10:12.679 I think it's related to the Good Sciencing. I wrote 0:10:12.679 --> 0:10:16.200 about this probably a year or so ago. I went 0:10:16.200 --> 0:10:18.000 through the list of people that they had on at 0:10:18.000 --> 0:10:20.720 the time. There was about one hundred, just a little 0:10:20.720 --> 0:10:23.520 over one hundred people that they claimed and died. There 0:10:23.600 --> 0:10:28.360 were soccer referees on there. There were retired athletes, there 0:10:28.360 --> 0:10:30.800 were people. One guy was out for a hike he 0:10:30.920 --> 0:10:34.680 was listed there. Now, you could argue a soccer referee 0:10:34.840 --> 0:10:38.240 is athletic, certainly, you know, running around the pitch and 0:10:38.360 --> 0:10:43.040 doing that. I could see that. But that person died 0:10:43.160 --> 0:10:46.680 at home in their sleep, not in competition. The retired 0:10:46.720 --> 0:10:50.320 soccer player had been retired for six or seven years. 0:10:50.600 --> 0:10:53.280 So even in the cases where they have athletes, they're 0:10:53.360 --> 0:10:56.839 really stretching what we would define as an athlete. 0:10:56.840 --> 0:10:59.800 Right, Yeah, I wonder is it data to show that, 0:11:00.120 --> 0:11:04.280 like overall mortality is lower in people who are vaccinated 0:11:04.400 --> 0:11:07.800 than unvaccinated, Like that exists yet? 0:11:08.480 --> 0:11:11.160 Yeah, so that's what some of these studies that I 0:11:11.160 --> 0:11:16.040 talked about that were done earlier this this year, there 0:11:16.080 --> 0:11:18.840 was a it was a Jack study the journal American 0:11:18.960 --> 0:11:24.240 College of Cardiology showed that even people who are partially vaccinated, 0:11:24.559 --> 0:11:29.440 there's a reduction in these cardivocular complications. And the Gama 0:11:29.520 --> 0:11:32.520 study which was done earlier specifically focused on am I. 0:11:32.600 --> 0:11:35.160 So the heart attacks at cute my cardinal functions and 0:11:35.240 --> 0:11:37.040 stroke also lower risk. 0:11:47.600 --> 0:11:50.000 You were saying earlier that there might be some sports 0:11:50.040 --> 0:11:53.320 that that had even higher rates than those those ones 0:11:53.360 --> 0:11:54.760 you mentioned overall for athletes. 0:11:55.120 --> 0:11:56.240 What sport to those? 0:11:57.440 --> 0:12:02.120 Yeah, so the one that's bit'sman raised recently is basketball. 0:12:03.640 --> 0:12:06.120 They were at least in some of these studies done 0:12:06.760 --> 0:12:11.800 in the US, much higher than other sports. Yeah. So, 0:12:11.880 --> 0:12:14.840 I mean, you know, basketball is can be an aerobic 0:12:15.960 --> 0:12:17.840 event and that you're running back and forth, you know, 0:12:18.000 --> 0:12:21.400 up and down the court quite frequently, but it's punctuated 0:12:21.400 --> 0:12:24.360 by these bursts of of you know, sprints and things 0:12:24.440 --> 0:12:27.480 like that, which some have speculated that might kind of 0:12:27.480 --> 0:12:30.880 be the issue, right, that you don't settle into just 0:12:31.040 --> 0:12:33.120 a simple rhythm. I'll say simple rhythm, like you know, 0:12:33.400 --> 0:12:36.400 like riding a bike is. It's not it's obviously simple 0:12:36.440 --> 0:12:42.400 as as you describe it, but at least potentially there 0:12:42.440 --> 0:12:44.600 there's periods of time when you can sort of get 0:12:44.640 --> 0:12:47.040 into a rhythm and stay there. And here it's it's 0:12:47.920 --> 0:12:52.080 rest periods punctuated by these rapid bursts. And so there's 0:12:52.160 --> 0:12:55.359 the possibility that that may be related. 0:12:54.960 --> 0:12:57.439 There, okay, and so that that might be why that 0:12:57.520 --> 0:12:59.120 there are higher death rates to there. 0:12:59.280 --> 0:13:02.880 It's possible. Yeah, they're not sure why these things happen 0:13:02.960 --> 0:13:04.400 to specific. 0:13:04.320 --> 0:13:05.840 Sports, Okay. 0:13:05.960 --> 0:13:08.800 Our our friends in the anti vax community show in 0:13:08.840 --> 0:13:11.000 their own minds why these happened, Like do they have 0:13:11.120 --> 0:13:12.920 some kind of hypothesis they're advancing. 0:13:14.160 --> 0:13:17.679 Uh no, So that's a good point. They'll say it's 0:13:17.720 --> 0:13:21.000 the spike protein. I'm sure I've heard that race before, 0:13:22.679 --> 0:13:28.760 but they don't really explain beyond that. It's interesting about 0:13:28.800 --> 0:13:32.480 the spike protein in the vaccines, as it's been modified 0:13:33.720 --> 0:13:38.680 to not be active, and so you have the spike 0:13:38.760 --> 0:13:44.559 protein in the virus which causes injury and yet they 0:13:44.559 --> 0:13:48.160 don't seem to, you know, acknowledge that that could cause 0:13:48.240 --> 0:13:51.520 these these issues. And yet the spike protein in the vaccine, 0:13:51.520 --> 0:13:56.240 which has been designed to limit that injury, somehow overcomes 0:13:56.240 --> 0:13:58.680 that and actually causes the injury that's not associated with 0:13:58.840 --> 0:14:02.040 the the infect like, like not that it makes sense, right, 0:14:02.240 --> 0:14:05.000 You have to work live in these parallel worlds that 0:14:05.160 --> 0:14:06.319 don't don't ever. 0:14:06.240 --> 0:14:10.400 Mix, right, Yeah, so they yeah, they're suggesting that this protein, 0:14:10.440 --> 0:14:12.960 which is a modified version of the one that's already 0:14:12.960 --> 0:14:15.280 in the virus but it's non harmful with one of 0:14:15.280 --> 0:14:19.359 the virus, is harmful. It's because of the modification. 0:14:20.240 --> 0:14:23.760 Yeah, Certainly a good number of people who don't like 0:14:23.800 --> 0:14:29.760 the vaccines also claim that covid itself is really not 0:14:30.400 --> 0:14:33.600 much of a threat. And then so again I don't, 0:14:33.680 --> 0:14:36.320 I don't. I don't see how they can reconcile these 0:14:36.600 --> 0:14:39.160 these points, right, especially when you're arguing about the same protein, 0:14:39.200 --> 0:14:41.920 one of which has been modified to be less active, 0:14:41.960 --> 0:14:44.120 and yet you're saying the less active one is actually 0:14:44.160 --> 0:14:46.800 more dangerous than it Just doesn't make. 0:14:46.720 --> 0:14:49.080 Any sense, right, Yeah, And I think it's kind of 0:14:49.120 --> 0:14:52.320 not Uh. People may be come to it with with 0:14:52.400 --> 0:14:55.160 a sort of predetermined desire to conclude that the vaccine 0:14:55.200 --> 0:15:00.720 is dangerous, and I wonder, like I'm familiar with exerting 0:15:00.800 --> 0:15:03.960 cardiac death from my time cycling, and I remember in 0:15:03.960 --> 0:15:06.800 the early two thousands, there was this idea that people 0:15:06.840 --> 0:15:09.560 were dying because their blood had turned like quote I'm 0:15:09.640 --> 0:15:12.920 quoting from like newspaper articles at the time, too treacle 0:15:13.840 --> 0:15:16.520 and had become so thick that their heart couldn't pump 0:15:16.560 --> 0:15:20.360 it anymore, and that this was causing people to die, 0:15:20.440 --> 0:15:22.400 and the reason that they died was because they were 0:15:22.440 --> 0:15:27.000 taking excessive amounts of blood boosters like EPO or exog 0:15:27.120 --> 0:15:32.240 a CPO, and so I this wasn't true, at least 0:15:32.280 --> 0:15:34.440 to my knowledge. I don't think any of these people 0:15:34.440 --> 0:15:39.120 had tested positive. None of them had like autopsies that 0:15:39.160 --> 0:15:42.760 suggested that this is why they had died. But it 0:15:42.840 --> 0:15:47.360 seems to me that there's this natural desire to try 0:15:47.400 --> 0:15:50.360 and explain away these deaths of what people who are 0:15:50.360 --> 0:15:53.040 at the peak of their physical lives right people in 0:15:53.080 --> 0:15:55.880 their in their teens and twenties, are extremely fit, who 0:15:55.920 --> 0:15:58.680 we can see doing amazing things, and doesn't sort of 0:15:58.760 --> 0:16:00.560 line up for us when they die. It doesn't end 0:16:00.600 --> 0:16:02.160 up with what we think a healthy person is, and 0:16:02.160 --> 0:16:05.920 what we think a cardiac patient is, and and and 0:16:06.000 --> 0:16:08.800 so it seems to me that we create these explanations. 0:16:09.000 --> 0:16:11.960 Is that something you've seen in other areas before the 0:16:12.000 --> 0:16:15.960 COVID vaccine without either sort of conspiracies or just ways 0:16:15.960 --> 0:16:17.200 to try and explain this away. 0:16:18.360 --> 0:16:20.680 I don't know about conspiracy. I mean I think people 0:16:21.280 --> 0:16:25.440 understandably have a hard time reconciling what you just said. Right, 0:16:25.520 --> 0:16:30.680 you have belite cyclists or whatever sport it is. I mean, 0:16:30.760 --> 0:16:33.040 cycling is good because aerobically they have to be very fit, 0:16:33.160 --> 0:16:36.480 and then they die potentially of a cardiac condition. Right, 0:16:36.520 --> 0:16:41.320 So that makes no sense, you know. So the easiest thing, 0:16:41.400 --> 0:16:43.440 like you said, is to well, they must be doping, 0:16:43.480 --> 0:16:46.320 they must be taking steroids and you know, something that's 0:16:46.360 --> 0:16:49.640 going to harm your body. And so that has to 0:16:49.640 --> 0:16:53.680 be the explanation because it's it's it's easy. That's a 0:16:53.720 --> 0:16:56.560 simple way to get to this. The reality is that 0:16:57.080 --> 0:17:02.480 a good number of these people have underlying cardiac conditions. 0:17:02.480 --> 0:17:04.560 Not again, I don't necessarily mean a lot of cyclists 0:17:04.560 --> 0:17:06.239 have that. What I mean is the people who have 0:17:06.280 --> 0:17:10.480 these sudden cardiac deaths have undiagnosed cardiac conditions long QT. 0:17:11.520 --> 0:17:15.200 There's a condition called CPVT, you know, something like that, 0:17:16.119 --> 0:17:22.280 and so they're relatively i'll say benign. CPVT isn't necessarily 0:17:22.320 --> 0:17:26.880 but it's triggered. These things are triggered by stressful events 0:17:26.920 --> 0:17:29.400 like exercise and things like that. And so they may 0:17:29.520 --> 0:17:33.040 live a good part of their life in it to 0:17:33.080 --> 0:17:37.040 be in our seemingly in good health, and then the 0:17:37.119 --> 0:17:40.960 first sign for any of these people is death. That's 0:17:41.200 --> 0:17:45.160 the real challenge in dealing with with these these cases 0:17:45.200 --> 0:17:47.800 that lead to ser cardiac death, because that's the first symptom. 0:17:48.160 --> 0:17:52.440 People don't feel tired, they don't you know, have chest 0:17:52.480 --> 0:17:54.680 pains like having a heart attack or anything like that. 0:17:55.000 --> 0:17:57.919 It's simply something happens. The wiring goes off in the 0:17:57.920 --> 0:18:00.680 heart and you put the exercise on top of it, 0:18:00.960 --> 0:18:04.800 and they die. You know, it's not just these athletes. 0:18:04.880 --> 0:18:07.680 You'll have somebody who has a change in one of 0:18:07.720 --> 0:18:10.840 their genes. They're perfectly fine. Do they live into their 0:18:10.880 --> 0:18:14.560 sixties and then they suddenly die. Well, what allowed them 0:18:14.560 --> 0:18:18.399 to live sixty years with you know, no symptoms. We 0:18:18.480 --> 0:18:21.720 don't really know. But it's not uncommon that the first 0:18:21.760 --> 0:18:26.159 symptom is death and these people. So your friends there 0:18:26.320 --> 0:18:29.680 who you know, it's it's easiest to accuse them of 0:18:29.960 --> 0:18:32.640 doping because certainly we a lot of us talked about 0:18:32.640 --> 0:18:35.080 it at the time, as I'm sure you know you 0:18:35.320 --> 0:18:40.359 knew about it. There's no secret. So we connect those dots, right, 0:18:40.400 --> 0:18:42.600 we can see that, we can see that, let's connect them. 0:18:42.640 --> 0:18:45.199 We can't let's see long QT. So we don't know 0:18:45.200 --> 0:18:47.199 what long QT syndrome is. For a lot of people, 0:18:47.640 --> 0:18:49.399 it's hard to make that connection when you don't know. 0:18:49.960 --> 0:18:52.480 Yeah, and it's hard from the perspective of being Simone's 0:18:52.480 --> 0:18:54.000 friend or I can only imagine what it's like for 0:18:54.040 --> 0:18:57.639 their families to have this, Like I guess them be 0:18:57.800 --> 0:19:01.960 sort of liblef do they die, you know, or sort 0:19:01.960 --> 0:19:04.280 of a cue of something that they may in many 0:19:04.280 --> 0:19:06.320 cases I don't think did do It must be very 0:19:06.320 --> 0:19:09.240 difficult to deal with that on top of losing someone 0:19:09.280 --> 0:19:09.600 you love. 0:19:10.440 --> 0:19:12.920 Yeah. Well, and we're seeing that again here with the 0:19:13.240 --> 0:19:17.720 people who oppose the vaccines, which is either they're assuming 0:19:17.840 --> 0:19:22.840 things or they're speculating on things. And you know, unless 0:19:22.840 --> 0:19:27.000 you're in the circle of care, you don't know what's 0:19:27.160 --> 0:19:29.920 what's going on. So you know, you talked about Lebron 0:19:30.040 --> 0:19:34.159 James on here. You know, does he have an ununderlying condition? 0:19:34.400 --> 0:19:36.840 We don't know, and it you know, it's it's really 0:19:37.000 --> 0:19:39.040 not helpful for me to sit here and say, well, 0:19:39.400 --> 0:19:41.760 he could have long QT, he could have CpG bet 0:19:42.040 --> 0:19:45.119 like here, you know, to speculate like like that. I 0:19:45.160 --> 0:19:48.240 can talk about what are some things that lead to 0:19:48.320 --> 0:19:52.239 these these conditions generally in people, But I don't know 0:19:52.280 --> 0:19:55.639 anything about his health, and so it's not helpful for 0:19:55.680 --> 0:19:57.479 me to sit here and speculate on that while his 0:19:57.560 --> 0:20:00.159 family and then he himself is trying to you know, 0:20:00.160 --> 0:20:02.479 sort to get through that. That's you know, that's I'm 0:20:02.520 --> 0:20:04.640 sure that's upsetting for them. So I'm not sure why 0:20:04.640 --> 0:20:08.399 people feel the need to do that except to advance 0:20:08.440 --> 0:20:09.600 their own agenda. 0:20:09.280 --> 0:20:12.000 Right, Yes, yeah, I think that is the case. So 0:20:12.840 --> 0:20:15.040 let's talk a little bit about how we can I guess, 0:20:15.040 --> 0:20:19.320 mitigate these risks that exist. I remember when I remember 0:20:19.320 --> 0:20:22.640 when you're getting a license in Spain and they make 0:20:22.680 --> 0:20:25.040 you take a cardiac stress test there, like you get 0:20:25.080 --> 0:20:26.639 you ride your bike on a treadmill and they just 0:20:26.720 --> 0:20:28.200 ramp it up until your heart rates in the one 0:20:28.280 --> 0:20:31.400 nineties or whatever. And I don't know what they were doing, 0:20:31.920 --> 0:20:34.639 but they made us I think that may only have 0:20:34.680 --> 0:20:36.840 been for like elite athletes, but they made us all 0:20:36.840 --> 0:20:40.480 do that. Is that something where if there was an 0:20:40.560 --> 0:20:42.920 underlying one of these underlying risk factors that you mentioned, 0:20:43.040 --> 0:20:45.120 would would it be spotted on a test like that? 0:20:46.400 --> 0:20:50.080 Yeah, that's a little bit of a controversial area. So 0:20:50.160 --> 0:20:55.280 I noticed you said in Spain. In Europe, the consensus 0:20:55.400 --> 0:20:57.920 is that athletes need to go through these what we 0:20:58.000 --> 0:21:02.239 called pre screening. So you were probably yeah, probably had 0:21:02.240 --> 0:21:05.320 electrodes on your body. Yeah, yeah, And so that's a simple, 0:21:05.359 --> 0:21:10.960 non evasive test, and so you're right because some things 0:21:10.960 --> 0:21:15.199 you can pick up just rest, but some of these 0:21:15.240 --> 0:21:18.080 things don't appear until you stress the individual, and so 0:21:18.520 --> 0:21:22.480 they'll look for rhythm problems. The other test is what 0:21:22.480 --> 0:21:25.240 we call eco cardiography, which is basically an ultrasound of 0:21:25.280 --> 0:21:27.960 the heart, and there you can look at function, but 0:21:28.000 --> 0:21:30.600 you can also look at structure. Because there's a condition 0:21:30.680 --> 0:21:37.080 called hypertrophic cardiomopathy. It's relatively common in athletes, it's more 0:21:37.119 --> 0:21:40.720 common there, and that accounts for about fifty percent of 0:21:40.720 --> 0:21:44.520 these sudden cardiac deaths, and so you can pick that 0:21:44.640 --> 0:21:46.639 up on an ECG but you can also pick it 0:21:46.720 --> 0:21:49.399 up using ultrasounds. So if you scan the heart you 0:21:49.440 --> 0:21:52.960 see that it's very large, that would be a diagnosis. 0:21:53.200 --> 0:21:56.919 So first in Europe they do that. In North America 0:21:57.040 --> 0:22:00.639 and Canada and the United States they do not. The 0:22:00.840 --> 0:22:04.320 concern is there's a couple of concerns. One is the price, 0:22:05.119 --> 0:22:09.320 so you can you're screening large numbers of athletes to 0:22:09.600 --> 0:22:14.399 pick out a relative small number who may be affected. 0:22:15.119 --> 0:22:17.600 It's crude, but that is an argument that people make. 0:22:18.400 --> 0:22:20.200 So I guess the question comes down to how much 0:22:20.359 --> 0:22:22.040 is life worth to you and how much do you 0:22:22.080 --> 0:22:24.439 want to spend. So there is that, But there is 0:22:24.520 --> 0:22:28.520 another issue, which is what they call false positives. So 0:22:29.400 --> 0:22:32.399 you know, had you been diagnosed as having a condition, 0:22:32.440 --> 0:22:34.120 that you maybe pulled out of training for a little 0:22:34.119 --> 0:22:36.760 while while they do more tests and stuff like that, 0:22:36.760 --> 0:22:40.760 that could be very stressful on you. And so the 0:22:41.400 --> 0:22:44.840