Getting to the "Heart" of the Matter.

[Sage11]

Updated: July 22, 2005, 4:27 PM ET

WCC player of the year's pro career in jeopardyBy Andy Katz

ESPN.com

Ronny Turiaf, the West Coast Conference player of the year at Gonzaga and a second-round pick of the Los Angeles Lakers, has an enlarged aortic root in his heart and will need open-heart surgery, possibly ending his pro career before it starts.

"I'm going to try everything I can to beat it," an emotional Turiaf said Friday.

My question to the Board is this: is Curry a similar case waiting to happen? Do we know, and do we still take the risk of bringing him here?

[KB21]

That's the unknown factor. It is possible. Anytime you have an arrythmia, the possibility for a serious problem exists.

[flava]

turiaf, who i thought would be a great fit for the hawks, has a dilated aortic root, which is where the heart interfaces with the great vessel that carries blood to the rest of the body. a dilated aortic root (which is basically big, loose and weakened) is at risk to rupture. when the aortic root ruptures (sometimes due trauma, sometimes just a matter of time, rarely due to an infection), one basically exsanguinates (bleeds to death). there are a variety of methods to 'reinforce' the vessel, almost all of which require a thoracotomy (or opening the chest in the operating room). that surgery is the real deal and carries greater risk than most surgeries....

curry has an arrhythmia, or a heart which is at risk for an abnormal electrical rhythm. arrhythmias come in many different varieties, ranging from not that serious to life threatening. the bad ones can be due to previous heart attacks (probably not curry's issue), an infection of the heart (j. howard of the rockets), abnormal development of tissue in the heart (likely curry's problem, len bias' problem [i believe]), severe electolyte abnormalities or drugs and toxins (like cocaine). i find the fact that curry doesn't want to take the test for the inherited cardiomyopathy (inheritied disease of the heart) to be quite interesting. he's probably been tested (under an assumed name as he probably just paid for the test) and was positive.

i personally would want dalembert over curry, but if we could get curry with a waiver, i suppose it would be better than collier.

flava

[Weez]

I missed the whole, 'he won't take a test to determine cardiomyopathy' bit. when did this happen?

any speak of whether or not he'd submit to a tissue sample?yeah pathology!!

[DominiqueWilkins]

Well it's Curry's heart beat, and he can take pills to semi handle the problem. Also it might not even bother Curry, but an enlarged heart like Turiaf's is a totally different thing.

[chazhrt]

I only read on this board, but I have to respond to the question of Turiaf and Curry's heart ailments. Let me begin by telling you that I am a heart surgeon in Los Angeles, and I have seen both ailments. Turiaf's disease can be cured by surgery. If his aortic valve is also involved it will have to be replaced or repaired. If it is replaced, his basketball career is over because he will have to take blood thinners. Curry is another problem. His problem can be cured by surgery or medical therapy. The problem is can the aberrant area causing his arrythmia be isolated and then ablated? Curry has a much greater risk of sudden death than Turiaf, now that Turiaf's condition has been diagnosed properly.

[TheDude]

holy chit, i just learned more about the heart in two replies than i've know my entire life...

let's get dalembert.

[DominiqueWilkins]

Curry concerns me because of his size, weight, and he's not in the best shape. I still like him alot, but I would perfer Dalembert at this point, and hopefully we land him.

[Lascar78]

the test wouldn't determine if he has cardiomyopathy, it would determine if he is genetically pre-disposed to cardiomyopathy. He has subjected himself to all other medical tests

[KB21]

I'd be curious to see if Curry has ever been checked for Marfan Syndrome.

[Sage11]

Thanks for your response Doc. That is why I posed the question, Curry heart may not be worth the risk for the Hawks or for Curry himself. He needs to be diagnosed with a proper prognosis.

[Sage11]

Quote:

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I'd be curious to see if Curry has ever been checked for Marfan Syndrome.

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What is "Marfan Syndrom."

[Spiral]

Thanks to Flava & Chazhrt for their very informative posts. It's pretty cool to have Docs lurking on the boards to explain these issues. My profession is Aircraft Maintenance so I doubt I'll ever use my proffesional knoledge to explain anything on this board unless the Hawks have problems with their airplane. (which I hope never happens)

For Sage from WebMD...

Quote:

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What is "Marfan Syndrom."

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Heart Disease:

Marfan Syndrome

Marfan syndrome is an inherited disease that affects the connective tissue. Connective tissue is the most abundant tissue in the body and is a vital component to supporting the body's organs. Its primary purpose is to hold the body together and provide a framework for growth and development. It provides the strength and support to tendons, cartilage, heart valves and many other parts of the body, as well as strength and elasticity to the blood vessels.

For people with Marfan syndrome, the chemical makeup of the connective tissue isn't normal and as a result is not as strong as it should be.

Because connective tissue is found throughout the body, Marfan syndrome can affect many parts, including the bones, eyes, heart and blood vessels, nervous system, skin and lungs.

What Causes Marfan Syndrome?

Marfan syndrome is caused by a defect in the gene that encodes the structure of fibrillin and the elastic fibers, major components of connective tissue.

In most cases, Marfan syndrome is inherited. The pattern is called "autosomal dominant," meaning it occurs equally in men and women and can be inherited from just one parent with the disorder. People with Marfan syndrome have a 50% chance of passing along the disorder to their children. In rare cases, a new gene defect occurs due to an unknown cause. Marfan syndrome is also referred to as a "variable expression" genetic disorder, since everyone with Marfan syndrome has the same defective gene, but not everyone experiences the same symptoms to the same degree.

Marfan syndrome is present at birth. However, the condition may not be diagnosed until adolescence or young adulthood. It is fairly common, affecting 1 in 20,000 people and has been found in people of all races and ethnic backgrounds, but is more common in China.

What Are the Signs of Marfan Syndrome?

Sometimes Marfan syndrome is so mild, few, if any, symptoms occur. In most cases, the disease progresses with age and symptoms become noticeable as the changes in connective tissue occur.

On the outside, people with Marfan syndrome are often very tall and thin. Their arms, legs, fingers and toes may seem out of proportion, too long for the rest of their body. Their spine may be curved and their breastbone (sternum) may either stick out or be indented inward. Their joints may be weak and easily become dislocated. Often, people with Marfan syndrome have a long, narrow face and the roof of the mouth may be higher than normal, causing the teeth to be crowded. More than half of all people with Marfan syndrome have eye problems.

Internally, many changes occur within the body structures due to the abnormal connective tissue. About 90% of people with Marfan syndrome develop changes in their heart and blood vessels:

Blood vessels. The walls of the blood vessels, especially the aorta, the major artery that carries blood from the heart to the rest of the body, become weak and dilates (stretches). This increases the risk of aortic aneurysm, aortic dissection (a tearing or separating of the layers of the aorta) or rupture (bursting). This can result in medical emergency or even death.

Heart. The heart's valves, especially the mitral valve, can be affected by Marfan syndrome. The valve leaflets become floppy and do not close tightly, allowing blood to leak backwards across the valve (mitral valve prolapse, also called MVP).

MVP increases the workload on the heart and may cause symptoms of shortness of breath, feeling over-tired or palpitations (fluttering in the chest). The abnormal flow may cause a heart murmur, which can be heard with a stethoscope.

Over time, the heart muscle may enlarge and weaken, known as cardiomyopathy. It can progress to heart failure.

Another problem seen in Marfan syndrome is dilation (widening) of the aortic root, the area where the aorta meets the aortic valve. This can cause the aortic valve to become stretched and leak.

Arrhythmia (abnormal heart rhythm) may occur in some patients and is often related to MVP.

Other changes. The changes in lung tissue make people with Marfan syndrome at higher risk for developing asthma, emphysema, bronchitis and pneumonia. Decreased elasticity of the skin may cause stretch marks to occur even without changes in weight.

How Is Marfan Syndrome Diagnosed?

There is not one single test that tells you if you have Marfan syndrome. The doctor will perform a thorough physical exam of the eyes, heart and blood vessels and muscle and skeletal system, obtain a history of symptoms and information about family members that may have had the disorder, to determine if you have it.

Other tests, such as a chest X-ray, an electrocardiogram (ECG) and an echocardiogram will be used to evaluate changes in the heart and blood vessels, and detect heart rhythm problems.

If sections of the aorta are unable to be visualized through echocardiogram, or a dissection is already suspected, a transesophageal echocardiogram (TEE), MRI or CT scan may be needed.

How Is Marfan Syndrome Treated?

Marfan syndrome requires a treatment plan that is individualized to the patient's needs. Some people may not require any treatment, just regular follow-up appointments with their doctor. Others may need medications or surgery. The approach depends on the structures affected and the severity.

Lifestyle issues

Follow-up. Routine follow-up including cardiovascular, eye and orthopedic exams, especially during the growing years. Your doctor will discuss the frequency of follow-up with you.

Activity. Activity guidelines vary depending on the extent of the disease and symptoms. Most people with Marfan syndrome can participate in some type of physical and/or recreational activities. Those with dilation of the aorta will be asked to avoid high intensity team sports, contact sports and isometric exercises (such as weight lifting). Ask your cardiologist about activity guidelines for you.

Pregnancy. Genetic counseling should be performed prior to pregnancy because Marfan syndrome is an inherited condition. Pregnant women with Marfan syndrome are considered high-risk cases. If the aorta is normal size, the risk for dissection is lower, but not absent. Those with even slight enlargement are at higher risk and the stress of pregnancy may cause more rapid dilation. Careful follow-up, with frequent blood pressure checks and monthly echocardiograms is required during pregnancy. If there is rapid enlargement or aortic regurgitation, bed rest may be required. Your doctor will discuss with you the best method of delivery with you.

Endocarditis prevention. People with Marfan syndrome who have heart or valve involvement or who have had surgery to treat Marfan syndrome, are at increased risk for bacterial endocarditis. This is an infection of the heart valves or tissue which occurs when bacteria enters the blood stream. To prevent this, antibiotics should be given prior to dental or surgical procedures. Check with your doctor about the type and amount of antibiotics you should take. A wallet card may be obtained from the American Heart Association with specific antibiotic guidelines.

Emotional considerations. Learning you have a genetic disorder, such as Marfan syndrome, may affect you in many ways. You may feel angry, sad or scared. This can be related to the knowledge of having a disease. You may need to make changes in your lifestyle and having careful medical follow-up the rest of your life. Or there may be financial concerns. It may be also concerning to think about risk to future children. It is important to seek medical care from a physician who has experience in treating Marfan syndrome. Get accurate information. It may also help to seek genetic counseling to help understand the disease and your risk for passing it on to your children. The National Marfan Foundation can help provide you with information and support.

Medications

Medications are not used to treat Marfan syndrome, however they may be used to prevent or control complications. One medication that may be used is called a beta-blocker. Beta-blockers decrease the forcefulness of the heartbeat and the pressure within the arteries, thus preventing or slowing the enlargement of the aorta. Beta-blocker therapy is usually started when the person with Marfan syndrome is young.

Some people are unable to take beta-blockers because they have asthma or because of the medication's side effects, which may include drowsiness or weakness, headaches, slowed heartbeat, swelling of the hands and feet or trouble breathing and sleeping. In these cases, another medication called a calcium channel blocker is recommended.

Surgery

The goal of surgery for Marfan syndrome is to prevent aortic dissection or rupture and to treat problems affecting the heart's valves, which control the flow of blood in and out of the heart and between the heart's chambers.

The normal aorta measures about 1 inch (2.54 centimeters). Surgery is recommended when the diameter of the aorta is more than about 4.7 centimeters (depending on your height), or if the aorta is enlarging at a rapid pace. The decision to perform surgery is based on the size of the aorta, expected normal size of the aorta, rate of aortic growth, age, height, gender and family history of aortic dissection. Surgery involves replacing the dilated portion of the aorta with a graft, a piece of man-made material that is inserted to replace the damaged or weak area of the blood vessel.

A leaky aortic or mitral valve (the valve that controls the flow of blood between the two left chambers of the heart) can damage the left ventricle (the lower chamber of the heart that is the main pumping chamber) or cause heart failure. In these cases, surgery to replace or repair the affected valve is necessary. If surgery is performed early, before the valves are damaged, the aortic or mitral valve may be repaired and preserved. If the valves are damaged, they may need to be replaced.

If surgery is needed, you should consult with a surgeon who is experienced in surgery for Marfan syndrome. People who have surgery for Marfan syndrome still require life-long follow-up care to prevent future complications associated with the disease.

A better understanding of Marfan syndrome combined with earlier detection, regular follow-up care and safer surgical techniques have resulted in a better outlook for people with this syndrome. In the past, the average age of death for people with Marfan syndrome was 32 years old. Today, most people with the disorder live active, healthy lives well into their 70s, especially if they have surgery before they develop aortic dissection and have long-term follow-up care by an experienced team of health care providers.

[Watchman]

It seems more likely to me that Turiaf has Marfan Syndrome as he has the aortic weakness, and is slender. Curry is very "un-slender."

I am not necessarily opposed to signing Curry, but not for a long contract, and not for the maximum amount. In addition to the heart concerns, he is a pathetic rebounder for someone his size. Someone could possibly teach him some techniques, but if you don't have the desire to be a good rebounder, you won't be.

What happens if he signs a five year contract, and has to sit because of his heart conditions. We would at least have to keep him on the roster for the two year period, like the point guard we acquired earlier (sorry I just can't think of his name at the moment).

During that time, he would count against our cap, just as the aforementioned point guard did. Therefore, we would be unable to acquire a decent replacement for him.

If we are unable to get Dalembert, I kind of like Diesel's concept of hiring some "rent-a-center" type players such as Hunter, ZaZa, etc. for the time being, until a better situation arises, either by draft or, here's a novel concept, an unrestricted free agent.

I don't really see why we're going after Joe Johnson. We have a SG already (Childress). I don't really think they are going to play JJ at point guard. I don't want him interfering with Childress' development.

As for trading Childress, I'd sooner trade Smoove. Maybe in the long run Smoove becomes a better player, but for now I'd prefer Childress.

[Weez]

Curry DOES NOT look like Marfan's...and he has an arrythmia, not problems with his aorta (such as an aneurysm etc.).

Shaun Bradley...now he looked kinda Marfans'...but based on genotype, I'd have a very hard time entertaining the possibility that Curry has Marfan's.