According to University of South Alabama pediatric cardiologist Dr. Lynn Batten, a young athlete dies of sudden cardiac arrest every three days.
Current screening techniques for athletes consist of a physical exam and a questionnaire aimed at asking about important family history or symptoms associated with exercise. However, the screenings do not include electrocardiograms (EKG) or echocardiograms (echo).
The EKG is a recording of the electrical activity of the heart, and the echo captures images of the heart with ultrasound. “Both tests are completely painless and non-invasive,” said Dr. Batten, who serves as director of the division of pediatric cardiology at USA.
“The standard pre-participation questionnaire and exam may miss the most common cause of sudden cardiac death in athletes, hypertrophic cardiomyopathy, which can be picked up around 90 percent of the time on an EKG,” said Dr. Batten.
Hypertrophic cardiomyopathy is a condition in which the heart muscle becomes thick. The thickening can make it harder for blood to leave the heart, forcing the heart to work harder to pump blood. “This condition is more common than we once thought,” Dr. Batten said. “It occurs in one in 500 people - most individuals show no symptoms.”
Other leading causes of sudden cardiac death include congenital coronary abnormalities and commotio cordis, a sudden arrhythmic death caused by a chest wall impact, usually during competitive sports.
Dr. Batten said it is very important for all athletes to be screened for heart health. “The goal of pre-participation screening in young athletes is to raise clinical suspicion and recognize silent cardiovascular abnormalities capable of progressing or causing sudden cardiac death. “We do that by asking about cardiac symptoms, gathering a family history, and performing a physical exam.”
If the findings are positive, the athletes should be referred to a cardiologist for further work-up and should not be cleared for sports.
According to Dr. Batten, the current screening techniques might not be enough. “EKG’s are still not a mandatory part of pre-participation screenings,” she said. “An EKG and echo may not detect every condition that could cause sudden cardiac death, but it certainly improves the chances of detection compared to current screening techniques.”
Regardless of the current screening techniques, Dr. Batten says it is always important to be prepared for an emergency. “When you’re at a child’s sporting event, locate the fastest way to get on the field and locate the nearest automatic external defibrillator (AED),” she said. “Have an emergency plan in place, and practice it.” Dr. Batten also recommends that all coaching staff and students are trained in CPR.
On Aug. 16, 2014, Dr. Batten will partner with a local group, Heart for Athletes, to conduct a free heart screening event for 75 high school athletes at USA’s Springhill Avenue Campus from 9 a.m. to 4 p.m.
The Heart for Athletes heart screening will include a health history form, blood pressure check, an EKG, and a brief echo.
The screening should take about 20 minutes, and all EKG's and echos will be read by Dr. Batten. Other demonstrations, such as CPR and AED training, will be available for teens and their family members.
Dr. Batten recently gave an overview of this topic at the June Med School Café lecture. To view the lecture in its entirety, click here.