A Weekend at Bernier's said:
L K said:
I'm shocked that this wasn't picked up during any of his annual/semi-annual physicals with the team. Hope him the best in recovery.
LK, my question is this: how, after playing elite hockey for close to 20 years and pushing his physical limits for all that time, does this happen now?
It's tough to say exactly. Based on the limited details reported, Letang likely had a congenital cyanotic heart defect. That basically just means that there was a connection between the left side of his circulatory system (blood that goes to the body after getting oxygen from the lungs) and the right side of his circulatory system (either deoxygenated blood returning to the heart, or skipping the lungs).
What can happen in those situations is that someone who develops a blood clot (risk factors of a hockey player would include - trauma, prolonged air travel) can have a clot go from the legs (most common place) and instead of getting stuck in the lungs and becoming a pulmonary embolism, could instead skip the right side of the heart and get shunted through that hole in the heart and and go someone in the body, in this case, the brain to cause a stroke.
The other thing that can happen is that you get get a small air bubble that develops because of some of the abnormal flow of blood through the hole and that could cause more of an ischemic (lack of oxygen rather than a direct clot) type stroke.
The stroke itself isn't something I'm surprised at, it's more that one of the team doctors/physical staff didn't notice a small murmur at some point during one of his physicals. If it was really small it might have been very quiet, and sometimes these defects can actually look normal because you don't get abnormal blood flow when you ultrasound the heart, but at this point I think paying big money to a hockey player should probably involve a million and one tests to make sure they are healthy and stay healthy as you are paying them. Especially in a US based league that operates in a very investigation happy system.
EDIT: I should add that this is entirely speculation and it is tough to back-seat doctor based on a few select comments that get through the media filter. Letang very well could have been worked up to the nth degree with nothing abnormal ever being found. At the same time, you have situations like the Philadelphia Flyers medical team that were basically forcing players back out on the ice when they were clearly injured so I do have a bit of skepticism when it comes to professional athletes and how their health is handled.
Bottom line, Letang suffered a pretty dangerous medical condition but it also seems like there was limited effects of the stroke so hopefully he makes a full recovery.