Cardiac screening in young athletes yields mixed results
A screening program for top teen soccer players in England identified heart disorders associated with sudden cardiac death in one out of every 266 individuals. But among the eight athletes who eventually died of sudden cardiac arrest, six of them had normal electrocardiographic and echocardiographic findings.
The results underscore why clinicians and cardiovascular societies are divided on whether cardiac screening should be required before sport participation. Some issues may develop after screening, which can be expensive—initial and follow-up testing for this 11,168-athlete cohort cost more than $4.3 million. About 6.8 deaths occurred for every 100,000 person-years, researchers calculated.
But some experts believe detecting even a few abnormalities is worth the price.
Sanjay Sharma, MBChB, MD, the senior author of the paper published in the New England Journal of Medicine, told the Associated Press that more than two-thirds of the 42 athletes who were found to have high-risk conditions were given surgeries that allowed them to safely return to the field.
“I don’t want my athletes to die on me,” Kimberly Harmon, MD, a sports medicine specialist at the University of Washington who supports routine cardiac screening, told the AP. “If they have something that makes them more likely to die than the next guy, I want to know about it.”
European guidelines recommend EKG screening as part of pre-sport physicals, while the American Heart Association (AHA) calls for a thorough physical exam as well as a personal family and medical history. If red flags are detected during that process, the AHA suggests further testing.
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