Good indepth follow up on Steve Larsen

From Bend Bulletin:

39 years old, a pro athlete collapses and dies. How can this happen?
By Lauren Dake / The Bulletin
Published: May 21. 2009 4:00AM PST

Linda English, 44, of Bend, was running hard and fast.

She was nearing her first turn on the curve of the Cascade Middle School track during a Tuesday evening workout when someone in front of her collapsed.

“I thought he had a leg cramp,” she said.

Within minutes, approximately 40 runners started sprinting toward where Steve Larsen, 39, of Bend, former champion mountain bike rider, runner and elite triathlete, lay on the track.

“I started screaming, ‘Who is a medical professional?’” English said. “It was obvious we needed 911 on the phone, now. The next thing I know, two people are giving him CPR. … We got someone to call 911. Another group of people lined the road to Cascade Middle School. We wanted the ambulance to find him as soon as possible.”

As the running group watched the ambulance drive Larsen to the hospital, all they knew was he had a slight pulse.

Larsen was declared dead at 7:05 p.m. Tuesday. He died from sudden cardiac arrest, but what caused the cardiac condition remains unknown.

“There’s a lot of things that can happen,” said Deschutes County Medical Examiner Steve Cross. “And the problem here is this very vigorous, healthy, relatively young 39-year-old who is a world-class athlete dies while exercising.

“It’s not supposed to happen. It’s not supposed to happen, and it did.”

“Did exercise cause it to happen? No. He has something that has yet to be explained,” Cross said.

Cross said an autopsy showed no obvious signs of coronary heart disease. Larsen’s heart has been sent to a laboratory in the Midwest where it will be analyzed.

Michael Larsen, 41, of Bend, said his younger brother had been experiencing trouble breathing and had severe swelling of his legs a couple of weeks before he died.

“He hadn’t been able to complete his workouts,” Michael Larsen said.

When Bruce McLellan, a cardiologist with The Heart Center in Bend, heard Larsen had swelling of the legs and a hard time breathing, he said both dilated cardiomyopathy and myocartisis have similar symptoms.

“Myocartisis is an infection of the (heart) muscle; usually it’s viral,” McLellan said. “The infection can weaken the heart muscle fairly acutely and can develop fairly quickly.”

McLellan said the vast majority of times people recover without complications from a viral infection, which could range from the common cold to flu, but sometimes it can affect the heart. Why it infects the heart sometimes and doesn’t others is impossible to say.

“That’s the million-dollar question,” he said.

Cardiomyopathy is a weakening of the heart muscle, which makes it difficult for the heart to pump the proper blood flow in and out of the chambers. The weakening can be caused by a wide range of issues, such as high blood pressure, a heart attack or viral infections.

Michael Widmer, also a cardiologist with The Heart Center, said heart condition symptoms can be difficult to diagnose.

“When you’re young and you’re healthy and you have potential underlying conditions, it’s challenging to find them,” he said.

Both Widmer and McLellan said heart conditions can lead to symptoms like shortness of breath, or even to sudden death.

“For some, the first symptom is sudden death,” McLellan said.

The Heart Center offers heart screening for high school students and is in the process of expanding the program to adults. When discovered, cardiomyopathy can often be treated with drugs, according to the American Heart Association Web site.

For the community, grasping Larsen’s death has been difficult.

“Our vision of Steve is the healthiest, fittest guy you would ever know. He was an absolute specimen,” said Teague Hatfield, owner of FootZone, a local athletic store. “He’s always the guy who is faster and stronger than everyone else, and just a good guy.”

Michael Larsen, also an athlete, said he believes a grandfather died of a heart attack, and his father is in poor health. But he said he’s not aware of any family history of heart problems. He believes his brother did go to the family’s general practitioner once he had trouble breathing, but he wasn’t positive.

“He has four boys,” Michael Larsen said. “And we want to know. It’s just so sad. If there are some kind of heart issues it would be good to know. Anytime you can learn from science it’s only going to help out in the long run.”

Max King, of Bend, who runs the workout group Larsen was participating in, said the moment Larsen hit the ground, people were around him doing whatever they could. “The response from the group, we had several nurses and a P.A., multiple people knew CPR and the treatment we gave him was as good as we could get at the time,” he said.

King said it was a traumatic experience for everyone, but he’s glad Larsen wasn’t alone when he collapsed.

“I’m thankful he was with people when it happened,” he said.

Lauren Dake can be reached at 541-419-8074 or at ldake@bendbulletin.com.