MANILA — Hypertrophic cardiomyopathy (HCM) remains a leading structural cause of sudden cardiac death (SCD) among young athletes, driving a critical need for early medical screening and precision intervention.
University of the Philippines-Philippine General Hospital (UP-PGH) Heart Failure and Cardiomyopathy Section Head Dr. Lauren Kay Evangelista-Galindez, during a session at the Philippine Heart Association's (PHA) 56th Annual Convention and Scientific Meeting on Wednesday, presented data showing that structural heart disease accounts for 70 percent of sudden cardiac deaths in sports populations, with HCM presenting a baseline global prevalence of approximately 0.2 percent.
Health experts note that the condition is disproportionately higher among specific high-risk cohorts, notably male basketball and football players.
Evangelista-Galindez also cited a 2024 study tracking 1,102 National Collegiate Athletic Association (NCAA) athletes underscored the statistical burden of cardiac events.
While perinatal accidents caused the majority of fatalities at 50.8 percent, direct cardiac involvement accounted for 13 percent of all deaths.
Among autopsy-proven cardiac deaths, idiopathic left ventricular hypertrophy (LVH), possible cardiomyopathy, and confirmed HCM constituted the highest individual share at 12.7 percent, followed by coronary artery abnormalities at 8.5 percent.
"And if you look at the exertional status at the time of death of these patients, highest is exertional status for coronary artery anomaly, arrhythmogenic cardiomyopathy, CAD and hypertrophic cardiomyopathy composed of around 53 percent," she said.
She added that the medical community has significantly adjusted historical protocols that previously banned HCM patients from competitive sports.
Data from the Lifestyle and Exercise Hypertrophic Cardiomyopathy (LIVE-HCM) study showed that the probability of experiencing a major adverse cardiac event was statistically similar between HCM patients who engaged in vigorous activity and those who did not.
According to updated clinical considerations published in December 2025, restrictions on competitive sports are no longer applied as a blanket rule.
"Vigorous physical activity or competitive sports restriction is actually not indicated for patients with hypertrophic cardiomyopathy," she said.
"It's reasonable to consider competitive sports participation for athletes with hypertrophic cardiomyopathy after comprehensive expert assessment with shared decision-making," she added.
Cardiovascular screening guidelines
The Philippines continues to rely on international standards for cardiovascular screening among children and athletes, while local medical groups work toward developing national guidelines tailored to Filipino patients.
In the absence of a universal local guideline in place, particularly for pediatric patients, schools and institutions have already been adopting recommendations from international organizations such as the American Heart Association (AHA) and the American Academy of Pediatrics (AAP).
“We abide by the American Heart Association and the American Academy of Pediatrics. They have a degree basically of the same. History, there’s this point in history and the physical exam. So it's the 14-point AHA,” UP-PGH Pediatric Cardiology Division Chief and Spokesperson Dr. Jonas del Rosario said.
The screening focuses on key warning signs, including “exertional chest pain, palpitations, family history,” as well as physical findings such as heart murmurs and other abnormalities.
Previously, the Philippine Pediatric Society created a task force in response to calls from pediatricians seeking clearer guidance on how to screen young patients.
Del Rosario noted that many schools and parents already require screening forms, especially for students involved in organized sports, varsity programs, and scholarship applications.
For adults and competitive athletes, former Philippine Heart Center Education, Training, and Research Services Deputy Executive Director Dr. Maria Teresa Abola said the PHA had already taken initial steps toward establishing a national framework.
“Through the efforts of three councils, the Council on Cardiac Rehab and Sports, Cardiology, Congenital Heart Disease, and Preventive Cardiology, had released a statement, a position statement at least, last February,” she said.
The statement contains recommendations for a national framework on pre-participation cardiovascular screening of athletes.
The recommendations include medical history-taking, physical examination, family history assessment, and the use of a 12-lead ECG, in line with AHA guidance.
Dr. Abola, on the other hand, said that mandatory ECG screening remains controversial because of issues involving cost, accessibility, and the shortage of trained interpreters.
She also underscored concerns about the availability of automated external defibrillators (AEDs), the interpretation of ECG results among adolescents, and the need to determine the true local burden of cardiovascular disease among athletes and young people.
“It’s really high time that we come together and plan this together, these guidelines for prevention,” she said.
