Should children and teenagers receive an electrocardiogram (EKG) before being allowed to participate in organized, competitive sports? An EKG captures the heart’s electric activity in a graphical format. The level of cardiac screening required before participating in sports is currently a topic of debate in the news and medical community. The question surrounding the how much cardiac screening young athletes should receive has gained visibility in recent weeks after the death of several student athletes from cardiac related events in early March, 2011.
Despite the fact that most student athletes are in top physical condition, only one out of 10 students who suffer sudden cardiac arrest survive. In most instances, the underlying heart condition is undiagnosed and sudden cardiac arrest is the first sign that a heart problem exists.
In 2007, the American Heart Association (AHA) issued guidelines for cardiac evaluation for students participating in sports. These guidelines include a physical exam and completion of a family history questionnaire. The questionnaire includes questions such as whether or not there is a history of familial heart disease under the age of 50, if they’ve ever fainted, experienced fatigue, or had chest pain during exercise. Follow-up evaluations are recommended depending on the results of the exam and information gathered from the questionnaire. The AHA guidelines do not recommend EKG screening.
Advocates of EKG screening indicated that many of the types of conditions which may lead to sudden cardiac arrest--such as hypertrophic cardiomyopathy--in children and teens are not detected by this type of screening. According to Dr. Kimberly G. Harmon, University of Washington Department of Orthopedics and Sports Medicine, 90 percent of the heart conditions that lead to sudden cardiac arrest in children and teenagers, and possible death, can be discovered by an EKG. Harmon believes that the use of an EKG will save lives and EKG’s should be a requirement for all students before participating in athletics.
The European Society of Cardiology (ESC) also recommends EKG cardiac screening for all student athletes as does the International Olympic Committee. Their position is strengthened by the results of a 2010 Italian study that reported the use of EKG’s reduced death from sudden cardiac arrest in student athletes by 89 percent. Skeptics remain unconvinced and cite a 1997 Israeli study which found no reduction in cardiac death in student athletes as a result of the use of EKGs.
Those not in favor of the use of EKGs also indicated that there is a cost involved for such screening. The argument is that since cardiac arrest is a relatively rare event, the cost to screen every student is relatively high in proportion to the number of actual lives saved. One suggestion is that the money would be better spent investing in a defibrillator for the locker room rather than EKG cardiac screening for each student.
In the meantime, the debate is not likely to be resolved soon. At present, parents should educate themselves about the advantages and disadvantages to EKG cardiac screening and discuss any concerns about their child’s risk for sudden cardiac arrest with their family physician.
For more information on sudden cardiac death in student athletes, you may want to visit the following related articles:
Hypertrophic Cardiomyopathy: Cause of Sudden Heart Attack in Young Athletes, https://www.empowher.com/cardiomyopathy/content/hypertrophic-cardiomyopathy-cause-sudden-heart-attack-young-athletes
Protecting Student Athletes from Sudden Cardiac Death: Cardiac Emergency Plans and AEDs for the Locker Room, https://www.empowher.com/cardiac-arrest/content/protecting-student-athletes-sudden-cardiac-death-cardiac-emergency-plans-and-
Sources:
Steven Reinberg, Few Student-Athletes Survive Sudden Cardiac Arrest, Health Day, 28 Jun 2010, http://abcnews.go.com/Health/Healthday/story?id=5265442&page=1
Sudden Cardiac Arrest, The Mayo Clinic, 12 Nov 2010, http://www.mayoclinic.com/health/sudden-cardiac-arrest/DS00764
EKG, The Free Medical Dictionary by Farlex, http://medical-dictionary.thefreedictionary.com/EKG
Rangel, MD, Should We Screen Teenage Athletes for Heart Disease?, 14 Mar 2011, http://rangelmd.com