According to the American Academy of Pediatrics (AAP), approximately 10 to 13 young athletes suffer from sudden cardiac death each year in the United States. Early detection of heart conditions allows for treatment and continued participation in many cases, along with peace of mind for players, parents, and coaches.
While standard pre-participation physicals can help identify possible problems, cardiac screening is considered the best method to identify and treat heart conditions. This targeted screening is designed to discover previously undetected heart abnormalities in athletes that appear to be in good heath.
To encourage athletes in all sports to be screened, many hospitals across the country have started offering tests to local high school athletes free of charge or for a small fee. The screening typically includes a detailed patient and family medical history and an echocardiogram, which uses ultrasound waves to assess the thickness, size, and function of the heart.
"There are many causes for sudden cardiac death," said Joel Okner, MD, a cardiologist on the medical staff at Condell Medical Center. "In athletes under the age of 35, the problem is usually a structural abnormality in the heart muscle, a condition known as hypertrophic cardiomyopathy."
Is it estimated this condition is the cause of approximately 90 percent of sudden cardiac deaths in young athletes. The good news is that once it has been detected, the condition can be treated, allowing continued sports participation.
Condell Medical Center Sports Medicine Department, near Chicago, launched its Heart-to-Heart cardiac screening program in February. Illinois' 6A State Champion football team, Carmel High School, was the first group to be tested. Screening results were provided to the players' parents and physicians. The ultimate goal of the Condell program is to screen every incumbent high school athlete in the local county.
"We have a responsibility to try to keep our athletes healthy," said Andy Bitto, Carmel High School athletics director and head football coach. "This screening is another technological advancement in saving lives."
A similar program, Arizona TOPS - Team Osteopathic Physicals for Students, is offered in Phoenix. The program run by 300 volunteers provides free physicals, including electrocardiograms, to about 2,000 high school athletes. Tests for vision, weight, height, blood pressure, hernia, range of motion and neurological functions, along with an EKG, and an echocardiogram are done. A similar exam, including the heart tests, can cost up to $500.
According AAP, a thorough patient history is the most important component of a heart screening evaluation. Further, AAP suggests parents complete any medical history forms with their children. This cardiovascular history should include questions about prior occurrence of chest pain or unexplained shortness of breath with exercise, past detection of heart murmur or increased blood pressure, and family history of cardiovascular disease, including premature death from heart disease of family members under 50 years old.
The American Heart Association states: Athletic screening should be performed by a healthcare worker with the requisite training, medical skills, and background to reliably obtain a detailed cardiovascular history, perform a physical examination, and recognize heart disease. Screening evaluations should include a complete medical history, and a physical examination, including brachial artery blood pressure measurements."
AAP advises that young athletes suspected of having a heart abnormality should be referred to a cardiologist for further evaluation before clearance for sports participation is given.
Please see the following links for further information about this issue:
American Academy of Pediatrics Sudden Cardiac Death Guidelines
American Academy of Family Physicians
Parents Handbook for Sports Medicine
Gatorade Sports Science Institute
American Academy of Pediatrics
The evaluation of any athlete, whether as a part of health evaluations prior to activity or as a diagnosis of an injury as the consequence of sports activities, is specific to that individual and the history and current state of the individual presented. Advice, diagnosis and treatment is individualized according to numerous factors, including patient health and age information, medical history and symptoms. All athletes should be cleared by a physician or other appropriate medical professional before engaging in physical activities and, after injury, diagnosis and treatment, for return to play.