For USC's Telfort, Heart Is the Matter

Frankie Telfort is no longer living on borrowed time, not that it's been easier for one of University of Southern California's top football recruits to pass.

"For the past few months since I got the news, I have been dealing with a little bit of depression," Telfort tells FanHouse. "It's kind of hard for a player who has been doing this that last 10 years of his life and was actually good at it. Then, I had to stop everything. It's been kind of tough for me."

A team of cardiologists in California and a follow-up diagnosis in Minnesota in July confirmed Telfort, 18, had hypertrophic cardiomyopathy (HCM), the thickening of the heart muscle that can constrain blood blow. It's the same condition -- commonly referred to as an enlarged heart --- that killed college basketball star Hank Gathers at nearby Loyola Marymount University nearly 20 years ago and Chicago Bears defensive lineman Gaines Adams in December.

The chances of that happening to Telfort, however, are slim. He's on medication and is seen periodically by a cardiologist.

No prescription is going to allow him to resume his playing career, one that showed so much promise as a linebacker out of Miami's Gulliver Prep.

"It's definitely bittersweet," Telfort says. "It's tough because I know my skills. It's hard to watch your team lose when you feel like you can contribute. I never got to test my skills out at the next level."

Minus USC's extensive screening of athletes, Telfort very well could have. As part of an athlete's physical, the American Heart Association only recommends the doctor use a stethoscope to detect murmurs or other audible signals that can flag heart trouble.

HCM, however, can usually be detected by an electrocardiogram (EKG),a test that detects electrical activity from the heart. In some cases, however, only an an echocardiogram -- a test that includes an ultrasound of the heart --- can flag HCM.

As part of an athlete's physical, the American Heart Association currently recommends a 12-point questionnaire and use of a stethoscope to detect murmurs or other audible signals that can signal heart trouble.

"This is a controversial area," says Euan Ashley, a cardiologist and professor at the Stanford School of Medicine. "There's a debate about whether we should take the next step that the International Olympic Committee and the European equivalent of the American Heart Association recommend. But it's a huge deal (since) there are a lot of athletes in this country playing high school and college sports."

About one in 500 people have HCM, although many may never have a clue since the disease can be silent. Ashley says that making every young amateur athlete undergo an electrocardiogram is controversial, since there would be false positives to deal with, not to mention the price tag such a mandate would include. His group is currently working on a cost effectiveness analysis of such screening to help inform the debate.

Schools such as USC and UCLA can rely on their medical schools to screen athletes, but that's not something every university has -- including dozens of Division I football schools.

Telfort sees both sides, although he says it should be studied when you factor in how many athletes are unknowingly putting themselves at risk.

"When you look at how many play sports in high school and college, it's pretty prevalent," Telfort says.

After his initial diagnosis at USC, Telfort traveled to the Minneapolis Heart Institute for a second opinion. He decided against seeking out a doctor somewhere in the nation that would clear him to play, which one expert says happens all too often.

"There is definitely doctor shopping," says Michael Lee, a cardiologist and assistant professor at the UCLA David Geffen School of Medicine.

Lee understands athletes who feel they are indestructible would be dismissive of a diagnosis, especially when there are dollar signs in the mix.

"Imagine you are an elite athlete who just got drafted and had a mega-million-dollar salary coming up," says Lee, who has not treated Telfort. "It's tough for me to say there is a risk you are going to die and you cannot play sports. It's something he's been working on his whole life and I am telling him it's not possible to pursue his dream. It's obviously a crushing thing for the patient and that natural response is sadness, anger and, often after that, doctor shopping."

Pro leagues have increasingly become more proactive on the subject in recent years.

The NBA became the first league in the U.S. to mandate all players are put through extensive cardiovascular testing -- including a stress test and an echocardiogram -- as part an annual physical four years ago. The NFL requires an EKG -- a test that measures that electrical impulses created by the heart -- but in the wake of the death of Gaines may soon require a stress test and an echocardiogram.

Once detected, those with HCM can typically lead normal lives, often with the aid of medications. In more advanced cases, an implantable defibrillator may be required and in some severe cases transplant may be necessary .

Telfort still has no symptoms and since there is no family history of HCM, he may never have known he is a candidate for a sudden cardiac episode.

"They thank God," Telfort says of his family's reaction to the diagnosis. "My life was spared. Both my parents took the news hard because they had certain expectations for me, but they told me when one door closes another one opens."

There's been at least two.

USC allowed Telfort to keep his scholarship on one condition: he had to help the team's coaching staff.

Naturally, Telfort gravitated to the defensive side of the ball.

"I was coaching linebackers," Telfort says "I know the position. I know a lot about football, period. A lot of the stuff that I saw, I pointed out [to coaches]. I made sure I was vocal."

Telfort is not sure what new USC coach Lane Kiffin has in store for him, but he says he already has an offer to join the staff at Western Kentucky.

Of course, that's if he doesn't go to medical school.

He's currently pre-med at USC and would like to pursue one of two medical disciplines: dermatology or cardiology, the latter of which comes with a job offer attached.

"My cardiologist (in Minneapolis) offered me an internship there to see if I like it or can develop a passion for it," Telfort says. "I think this could be a pretty good field for me."