The sound of the swoosh ended a thrilling season of basketball at Michigan's Fennville High School, but the victory turned tragic when 16-year-old star athlete Wes Leonard collapsed on the gym floor after shooting the winning basket.
According to Dr. David A Start, the forensic pathologist and medical examiner of Ottawa County, the cause of death was cardiac arrest due to dilated cardiomyopathy -- an enlarged heart -- a condition that often goes unnoticed.
Leonard's game-winning layup, which earned two of his 21 points that game, led the undefeated Fennville Blackhawks to a 57-55 win over Bridgman High School. Teammates hoisted in him the air moments before he collapsed.
"He made the shot and then the game was over, we had won, everyone rushed the court," said Tobias Hutchins, a senior at Fennville High School who was at the standing-room-only game. "He did the team lineups where they all shake hands, the basketball team held him up, he started walking, then collapsed."
The gym went quiet as coaches and players surrounded Leonard, who was lying on his back.
"Nobody knew for sure why he had collapsed and was suddenly on the floor," said Tim Breed, a spokesperson for Holland Hospital who was also at the game.
Suspecting possible heat exhaustion, people tried to and cool Leonard down with ice packs while waiting for the ambulance.
"There was a sense of the crowd being stunned and just being shocked," Breed said. "Those who were obviously close to him there were those who were crying so many people on their cell phones just a sense of disbelief. We had gone from a monumental high one minute literally a minute or two minutes later to this hushed sense of shock."
Paramedics performed CPR and took Leonard to a defibrillator on the court. Soon after he was rushed by ambulance to nearby Holland Hospital, where he died two hours later at 10:40 p.m.
Sudden death in young athletes is relatively rare, but a major concern among schools and professional organizations. It gained significant attention in 1990 with the death of 23-year-old Hank Gathers, a basketball star at Loyola Marymount University.
Gathers died after collapsing on the court during a game against the University of California, Santa Barbara. A medical examiner determined that Gathers, suffered from hypertrophic cardiomyopathy -- an enlargement of the heart due to thickening of the muscle walls.
According to a 2003 review published in the New England Journal of Medicine, hypertrophic cardiomyopathy is the leading cause of sudden death among athletes, accounting for roughly a quarter of deaths.
Dilated cardiomyopathy was implicated in only 2.3 percent of athlete deaths.
What led to Leonard's condition, which prevents the heart from efficiently pumping blood to the rest of the body, is unknown. According to the National Institutes of health, risk factors include heart disease or a family history of it, high blood pressure, vitamin or mineral deficiency, infections involving the heart muscle, and the use of certain drugs or medications.
Thirty percent of dilated cardiomyopathy cases are inherited, according to Dr. Steven Fowler, a cardiac electrophysiologist at the Cardiovascular Genetics Program at NYU Langone Medical Center.
Symptoms, such as shortness of breath, rapid and irregular pulse, chest pain and faintness, are often subtle and develop slowly over time. But they can be severe and come on suddenly.