Cardiac Evaluations Recommended for Young Athletes

This is a very controversial topic. Obviously the impact to a family who has lost a child is tremendous. However, on the other side the incidence of this type of event is quite rare estimated at around 1 in 100,000 sports participants of school age? Screening examinations in histories have not been typically thought to be useful in detecting a called heart disease. However, the electrocardiogram has not shown a significant difference in many populations in terms of increasing that yield. Some of the conflicting information includes reports from Italy that suggested the incidence of sudden death dropped dramatically after instituting a mandatory screening process. However, that final rate that they achieved was really only about the same rate as is present here in the United State already. In addition to subsequent study from Israel showed that there was no improvement in mortality after institution of a screening programme. The additional burden of running down the abnormal findings that so called false positives, is also something to deal with. It is a tremendous expense particularly for a rare disease. Many children do not have the resources to undergo this testing, and will opt not to do the recommended power. Additional testing that has been recommended includes the echocardiogram. This is a test where an image is made of the heart particularly to look for abnormal thickening of the valve muscle known as hypertrophic cardiomyopathy. Other conditions such as a poorly working heart muscle known as cardiomyopathy or abnormal valve structures and occasionally abnormal coronary arteries can be detected. However, this study is done in a screening fashion rather quickly in a period of about five minutes as opposed to a complete study which might take up to 45 minutes. The exclusion of coronary artery anomalies is not possible in the screening test, and these accounts were at the second leading cause of sudden death in young athletes. There are a number of other conditions that even with the complete echocardiogram and a very thorough electrocardiogram cannot be detected because they do not manifest on either of these tests. Such that the screening may give a fall sense of security to the participant, and that there is no heart disease whatsoever. Clearly, if there is a family history suggestive of heart disease that may be inherited, or there are warning signs or symptoms, and a list of these has been provided by the American Heart Association then that child deserves further evaluation. In addition we need to put efforts and to making sure that all the schools and all the sports facilities have AEDs available because clearly this has made a bigger impact on sudden death then the screening process.