PITTSBURGH (KDKA) -- Lifelong hockey player Josh Singleton died in 2003 as he was coming up the steps at home -- a sudden cardiac death.
"He really loved the sports," his mother Dawn said. "He was very, very athletic."
He was a student at Robert Morris University and the only child of Clarence and Dawn Singleton. He was 20 years old.
"They did an autopsy on him," Dawn Singleton said. "It came back he had hypertrophic cardiomyopathy."
There was no clear warning his heart was dangerously enlarged -- a genetic condition. Even needing to take shorter shifts during hockey games didn't signal his coaches, or even his doctors, to check further.
"He was tired and just sluggish some days," said his father, Clarence, "and whenever we took him to the doctor, they said, 'well, the activities he was playing, working, going to school, any child would be tired.' If they'd found it in my son earlier, he would probably still be with us today."
Inspired by their story, Pennsylvania Representative Robert Matzie co-sponsored Act 59, which was signed into law in July.
"If we could save one life, that's enough," says Matzie.
The legislation requires that parents and coaches of student athletes sign a form every year stating that they understand the risks involved in athletics, that they've reviewed the symptoms of potential heart problems during strenuous exercise and that they should seek a doctor's evaluation if these symptoms occur.
"As a parent myself, I want to know those symptoms, I want to know what dangers could potentially be there for my child," Matzie said.
"The most important red flags are fainting, chest pain and shortness of breath," says Dr. Vivekanand Allada, a cardiologist at Children's Hospital of Pittsburgh said. "They can feel palpitations, or their hearts skipping beats."
For football, basketball and track athlete Milton Sibanda, his symptoms were far worse. After running at a high school track meet, he felt suddenly cold and nauseous, then passed out. He was rushed to the local hospital, then Children's Hospital.
When routine tests came back normal, Sibanda was diagnosed with fainting and a bizarre migraine. But a specific protocol on his heart ultrasound led to a CT scan, which diagnosed his extremely rare problem. A main vessel that gives the heart its blood supply came off at the wrong place so that it got pinched during exercise.
"We were just sitting there and this herd of doctors came," he said. "Something in me just said, oh God, I'm dying. I thought they would just give me medicine or something, and they were like, well, you need open heart surgery."
The surgery opens and patches the vessel, so that oxygen rich blood comes directly from the aorta.
Act 59 was designed to identify athletes like Milton. But, as in his case, it's not so easy. He had normal tests and normal EKGs.
Even when he showed warning signs during basketball, they were hard to interpret.
"He was always the last one up the court after a rebound and I was like, you should be the first one up the court," says Melodie, who thought he was just being lazy. "I give a lot of credit to his basketball coach. Coach Nemec did not push him and he said, if you don't feel good, let me know."
In fact, in a study looking at a series of 180 cases of sudden cardiac death in sports, only 3 percent had an abnormality on the pre-participation physical.
Even in the best case scenario where we do all the right things, it can be easily missed.
Milton now runs track in college. A few months after his surgery, he was playing football. And just weeks afterward, he went to the prom.
"Parents shouldn't have to go through the agony, the loss of scheduling a funeral," Matzie said. "They should be scheduling a fitting for a prom dress."
"When I was growing up, even when a player got hurt on the field, the coaches would always say, suck it up, and get back out there and play," Clarence Singleton said. "So if something could change that. If you're hurt, send them for more extensive testing."
"One in three parents finds out their kids his this particular anomaly from an autopsy report," Melodie Sibanda said. "I'm just glad we found out when we did, because it could have been much worse."
Club sports and sports outside of school are currently exempt and Act 59 applies only to high school sports. If parents and coaches don't comply, the board of education will impose whatever liability it feels is necessary.
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