Bronny James is hardly alone

Allan Chaney staggered to a vacant chair at the end of an offseason workout, his vision fuzzy and his breathing labored. A team manager offered to bring Chaney some water. The Virginia Tech basketball player’s last memory is responding yes.

Only seconds later, Chaney passed out and fell from his seat, still cradling a basketball. He didn’t regain consciousness until a quick-thinking Virginia Tech athletic trainer administered CPR and chest compressions.

An ambulance rushed Chaney to a nearby hospital to undergo a battery of tests. Doctors at first thought he had a severe case of dehydration. Not until weeks later was Chaney diagnosed with myocarditis, a viral inflammation of the heart.

When Chaney traveled to Boston to consult with a renowned heart specialist, Dr. Mark Estes opened their visit by asking the 6-foot-9 forward what his major was. Chaney recalls Estes then telling him, "You’re going to have to put that major to use. You’ll never play basketball again.”

Chaney’s occasional sobs were the only audible sounds during his family’s two-hour drive home to New London, Connecticut. He kept thinking about how hard he’d worked to play in the ACC and put himself on the NBA’s radar, only to have those dreams smashed. He kept envisioning what it would be like to have a wireless defibrillator in his chest at age 20.

“When it happened, I felt so alone,” Chaney told Yahoo Sports. “I felt like I was the only person in the world my age who was going through something like this.”

Thirteen years later, Chaney has since discovered he’s not alone. He’s actually part of a large, star-crossed fraternity. Sudden cardiac arrest is the No. 1 killer of student athletes, according to the American Heart Association. Men’s basketball players are the most vulnerable, researchers who have studied the incidence rate among athletes say.

Sudden cardiac arrest has without warning killed high schoolers, college standouts, G-League journeymen and NBA All-Stars. It has halted the basketball careers of dozens of otherwise fit, young men. Now it has turned this generation’s greatest basketball player into a helpless dad.

Bronny James, the highly touted eldest son of LeBron James, was hospitalized Monday after suffering cardiac arrest during a workout at USC, a family spokesperson said. As of Tuesday morning, the 18-year-old McDonald’s All-American was in stable condition after a brief stint in the intensive care unit.

If Bronny emerges from this unscathed, it will be evidence of progress. Sudden cardiac arrest on the court was once a virtual death sentence for young basketball players, but a determined group of doctors, parents, coaches and athletes have fought tirelessly to change that. They’ve raised awareness of the threat and pushed schools to offer cardiac screenings for athletes, to make AEDs (automated external defibrillator) more accessible and to rehearse emergency action plans.

“Athletes are suffering cardiac arrest and walking out of the hospital,” said Sara Gould, a sports medicine physician in the UAB Department of Orthopaedic Surgery. “We’re seeing athletes walking away from these now where we didn’t necessarily see that before.”

Underestimating sudden cardiac death

Jonathan Drezner can pinpoint the exact moment when he first began paying attention to how many seemingly healthy athletes were dying from sudden cardiac arrest. It was the night when he watched a supremely talented peer stumble, collapse and never get up again.

Hank Gathers’ tragic death in 1990 lingered with Drezner long after Loyola Marymount finished honoring its fallen star with a stunning Elite Eight run in the men's NCAA tournament. Drezner began studying sudden cardiac deaths as he completed his own college basketball career at Brown University and went off to medical school.

In those days, medical journals often wildly underestimated the rate of sudden cardiac death in athletes. A 1998 study for example described the chance of sudden cardiac death for healthy, young people during exercise as less than 1 in 200,000. That same study dismissed the sudden cardiac death in competitive athletes as “very rare, despite the publicity.”

Drezner and colleague Kimberly Harmon used better data to produce a more precise estimate. Instead of sifting through only media reports to find examples of sudden cardiac death among NCAA athletes, Drezner and Harmon also combed catastrophic insurance claims and a database that from January 2004 to December 2008 logged athlete deaths and their causes.

The research revealed that the high-profile deaths of Gathers and Boston Celtics star Reggie Lewis weren’t mere anomalies. The rate of sudden cardiac death among NCAA athletes was about five times higher than what previous studies suggested. Male athletes were more than twice as vulnerable as women. Division I men’s college basketball players were the most susceptible at nearly 1 in 3,000.

There’s no indisputable evidence why male basketball players would be the most likely to suffer sudden cardiac arrest, but Drezner and his cardiologist colleagues offer several educated guesses. Basketball requires sudden bursts of cardiovascular effort that may be more likely to reveal heart disorders. Also, the tall, long-limbed body type that is ideal for basketball seems to increase the likelihood of issues that can affect the heart.

The disturbing numbers in Drezner’s study helped inspire the NCAA to bring him and 23 other leading sports medicine experts to Indianapolis in September 2014 for a two-day cardiac summit. That group made a series of recommendations for how universities can prevent and react to sudden cardiac arrest.

“There was a lot of good that came out of that,” Drezner told Yahoo Sports, “but honestly I don’t think it went far enough.”

To Drezner, the good was the NCAA strongly recommending that member schools implement an emergency action plan for cardiac arrest and rehearse it with appropriate medical personnel. The NCAA also urged schools to place AEDs in easily accessible locations and athletic trainers, team physicians and strength coaches to become certified in CPR.

What still rankles Drezner is that not all the other medical experts joined him in pushing for an electrocardiogram (EKG) and an echocardiogram to be required elements of preseason cardiac screenings. As a result, the NCAA grew wary of burdening athletic departments that lacked sufficient resources or access to physicians with appropriate training to interpret EKG and echocardiogram results.

The NCAA recommended only standard physical exams that included a verbal assessment of an athlete’s cardiac risk factors. EKGs and echocardiograms, it determined, were permissible but “not the solution, for now.”

An EKG measures the heart’s electrical activity to check for different conditions that would predispose someone to a sudden cardiac event. An echocardiogram allows doctors to examine the heart’s structure to look for the thickened wall that is a telltale sign of hypertrophic cardiomyopathy. Neither test is 100% effective in detecting at-risk individuals, but Drezner says together they’re “the best tools for heart screening.”

“The reason I say that I don’t know if we went far enough is that back then we already knew that college basketball players were our single highest-risk group,” Drezner said.” It’s disappointing that we weren’t ready to recommend that they all have an EKG. If you’re a sports medicine physician and you’re not using EKGs when taking care of men’s basketball players, I think you’re behind the times.”

The NBA and other major American professional sports leagues require players to undergo annual EKGs and echocardiograms. Drezner estimates that 75% of power-five universities do the same.

It’s unclear what sort of cardiac screening Bronny James received at USC. A USC spokeswoman declined to comment on even the school’s general protocol for incoming freshmen, citing student-athlete privacy concerns.

EKG exams and echocardiograms are far less common at the lower levels of college athletics and at high schools. In those levels, it often takes a dedicated volunteer group or charitable foundation to provide access.

Preparation saves lives

Western Kentucky guard Danny Rumph was playing pick-up basketball in Philadelphia in May 2005 when he collapsed and died of sudden cardiac arrest. No one at the Mallery Recreation Center was trained in CPR at the time. There were no AEDs on site.

Out of that horrific tragedy for Rumph’s family members came newfound purpose. They launched a new foundation with a mission of putting AEDs in every Philadelphia gym and rec center and providing CPR training for local coaches and making cardio screenings available to youth and high school teams in the area.

Philadelphia-area kids who participate in a Danny Rumph Foundation cardio screening answer questions about their family history and undergo an EKG exam. If a cardiologist finds red flags, the parents are urged to take their kids for more sophisticated testing.

“We do it every year, and every year we find three or four kids with some sort of issue,” said Marcus Owens, Rumph’s uncle. “I truly believe that if we save one kid’s life, it’s all worth it.”

Across the country in Southern California, the Heartbeat of Champions Foundation provides similar screenings for Los Angeles-area high school athletes. Co-founder Ed Cabico says that those screenings have sometimes uncovered “abnormalities that the parents had no idea their kids even had.”

“We’re trying to make people more aware that their kids need to be screened,” Cabico said.

Chaney wishes he had better understood the warning signs for sudden cardiac arrest 13 years ago when he collapsed during that fateful Virginia Tech workout. He actually defied doctor’s orders a few months later, participating in a pick-up game at a neighborhood YMCA, only to crumble to the floor and pass out a second time.

That convinced Chaney that something was actually wrong with his heart, but he never lost hope of playing again. He got a second opinion from Pennsylvania cardiologist Dr. Francis Marchlinski, who cleared him to return to the court if he got an innovative experimental wireless defibrillator to monitor his heart in case issues arose.

Chaney wanted to play for Virginia Tech, but school administrators wouldn’t take the liability risk. It was the same at other schools — all except lower-tier High Point (N.C.).

In his first season at High Point, Chaney started 27 games without incident and showed flashes of his old self. He was off to an even better start five games into the following season when he received “a life-saving shock” from his defibrillator while at the free-throw line against Wofford.

“At that point, I knew it was it,” Chaney said. “I knew it was time for me to hang it up. I loved basketball, but it wasn’t worth my life.”

Chaney learned that Bronny had suffered cardiac arrest when he awoke on Tuesday morning to a text message from his brother. Immediately, he began to wonder if LeBron’s eldest son was experiencing the same feelings of loss that Chaney once did.

The shock of having his heart stop when he was in peak physical condition. The pain of possibly giving up a passion and a key piece of his identity. The frustration of putting in years of work, only to have his basketball dreams abruptly disintegrate.

“I tell people all the time that I would never wish this on anybody, not even my worst enemy,” Chaney said. “It’s easy for someone to say Bronny is set. That’s not true. Bronny is 18. He has his own dreams that he wants to achieve. Unfortunately, those will be put on hold now.”