The condition that killed a 16-year-old football player Wednesday at Burrell High School causes sudden death so infrequently that reported deaths in the U.S. number fewer than two dozen.
An autopsy Thursday by the Allegheny County medical examiner’s office found that Noah Cornuet of Lower Burrell collapsed during football practice because of a benign heart tumor called an atrial myxoma. Noah collapsed early in practice about 6 p.m., after the team had finished stretching and was starting to split off for drills, according to players. He was taken to Allegheny Valley Hospital, where he was pronounced dead at 7:05 p.m.
“It’s a very unfortunate case and a very rare cause of sudden death — it’s not commonly seen in that context,” said Srinivas Murali, director of Allegheny General Hospital’s Division of Cardiovascular Medicine. “The problem with these myxomas is that they can start and slowly grow over time and you might not even know you have one. It’s very possible he had no symptoms.”
The condition is easily diagnosable through an echocardiogram when patients have symptoms, such as fainting or shortness of breath, said Dr. Murali, who is also the medical director of the Allegheny Health Network Cardiovascular Institute. Treatment is immediate removal of the tumor through open-heart surgery, he said, and the success rate is very high.
Cases of reported sudden death from atrial myxomas number only about 20 in American medical literature, Dr. Murali said.
Noah’s death occurred during Burrell’s first of three heat acclimation sessions, a measure to prevent heatstroke mandated by the Pennsylvania Interscholastic Athletic Association that took effect last year.
Deaths during football practice have received increased attention in recent years, with the National Football League adopting heat acclimation practices following the death of Minnesota Vikings lineman Korey Stringer in 2001 and the NCAA following suit in 2003.
“When you look at the heatstroke deaths since then, it’s been mostly high school deaths,” said Rebecca M. Lopez, an athletic trainer and director of the post-professional graduate athletic training program at the University of South Florida. In recent years, most states have adopted heat acclimation guidelines, according to the Korey Stringer Institute at the University of Connecticut, mandating several days of limited practice hours or not practicing in full gear.
Noah’s death was not heat-related, nor was it caused by hypertrophic cardiomyopathy, a disease that causes thickening of the heart muscle, the most common cause of cardiac sudden death for athletes.
It is possible, however, that his death may have been prompted by athletic exertion, Dr. Murali said. Atrial myxomas are tumors of the connective tissue that often grow as a ball connected to a stalk, with the ball able to flop around within the heart. “Physical exertion obviously results in the heart pumping more blood,” Dr. Murali said. “With the heart pumping more vigorously, the movement would be more vigorous. From that perspective, it’s possible that the exertion was contributory in some way.”
Even though they are not cancerous, the tumors are dangerous because when they grow big enough, they can completely block blood flow from the heart. .
Atrial myxomas are more common in women than men, and 90 percent of the time there is no family history of such tumors. Common symptoms include fainting, chest pain, palpitations, irregular heartbeat or difficulty breathing.
“If any testing was done” for such symptoms, “they would have picked it up,” but with no symptoms, the condition would not have been noticed on a routine physical, Dr. Murali said .
PIAA executive director Bob Lombardi said that “comprehensive physicals” are required for every player but heart scans or checks are at the discretion of individual physicians.
Noah’s teammates and coaches gathered early Thursday evening at the high school for the second scheduled acclimation practice, and local police officers were present to keep the media at a distance.
As they began to leave the school about 6:15 p.m., 12 players walked in a row down steps to the high school football field. When they reached the grass, each player took his light blue jersey off and tossed it into a pile, one by one. Then they threw the ball around on the campus where their friend had collapsed the day before.
Visitation will be from 6 to 8 p.m. Saturday and 2 to 4 and 6 to 8 p.m. Sunday at Duster Funeral Home, 347 E. 10th Ave., Tarentum. A service will be at 11 a.m. Monday at Puckety Presbyterian Church, 1009 Puckety Church Road, Lower Burrell. Attendees are asked to meet at the church, which is next to Burrell High School.
Anya Sostek: firstname.lastname@example.org or 412-263-1308. Craig Meyer: email@example.com. Lexi Belculfine contributed to this story. First Published August 7, 2014 12:00 AM