Should All Student Athletes Undergo Heart Screenings?
Reports about student athletes like Fennville High School (MI) star player Wes Leonard who suddenly collapse during a basketball game or–as happened a few months ago here in New Jersey–after a swim meet, and can’t be resuscitated are, it goes without saying, tragic and alarming. Leonard had just made the winning shot to cap his team’s perfect season, says CBS, when he collapsed on March 3; he was found to have died of an enlarged heart. While some communities, in response to more than understandable parental concerns, have started programs to have more extensive heart testing performed, an American Heart Association (AHA) task force does not support such programs, according to Science Daily.
As many as 10 to 12 million athletes participate in competitive athletics. The reason the AHA’s task force does not support such programs is that there is a lack of evidence that they are able to reduce the number of sudden deaths. The task force looked at pre-participation screening practices and the use of electrocardiograms (ECG):
A large trial recently completed in Israel concluded that mandatory ECG testing of athletes prior to sports participation did not reduce the number of deaths from sudden cardiac arrests.
“One of the major obstacles to developing a better screening process is that no one heart test is the best,” says Mark Russell, M.D., a pediatric cardiologist at the University of Michigan’s C.S. Mott Children’s Hospital. “There are a number of different heart conditions that can cause sudden death in a young athlete. “For some heart conditions, the ECG is the best test.
For other heart problems, an echocardiogram is required,” Russell says. “Unfortunately, both tests are usually normal in some individuals whose heart problem can only be diagnosed with an exercise stress test.”
Furthermore, some conditions such as hypertrophic cardiomyopathy, a thickening of the heart, or dilated cardiomyopathy, the cause of death of the Fennville, Mich. Teen, can develop over time. A single screening may not detect the condition.
The AHA emphasizes that it is of utmost importance that the ‘screening process outlined by the AHA is being performed as recommended.’ This process requires that 12 specific aspects of a student’s personal medical history, of her or his family medical history and a physical exam, be documented. If there are any concerns based on the initial screening, it is recommended that the a cardiologist be consulted.
As Science Daily notes, ‘the pre-participation screening form approved by the state of Michigan only covered five of the 12 topics recommended by the AHA.’ In other words, communities may think they are doing enough to screen student athletes, when they actually are not doing enough.
While it makes good sense that the 12 steps of the AHA’s screening process are followed, as a parent, I’m not quite ready to write off ECG screenings. A year ago, my son’s neurologist noted a small irregularity in his ECG (possibly due to some of the medications my son takes) and immediately told us to make an appointment with a cardiologist. We did and the cardiologist’s more sensitive instruments found that everything was fine with my son. My husband and I were were more than relieved to get those ‘everything is fine’ results. We’d be more than glad to do the test or other tests again, just to be sure.
There are some things you never can be too sure about.
Photo by Rennett Stowe.