Sudden cardiac death in athletes, while uncommon, is a terrifying thing for any parent of young athletes to ponder. Each year, about 100 to 200 pediatric sudden deaths are recorded in the United States. This means an estimated 1 to 2 children per 100,000 children die suddenly every year.
These sudden deaths are often caused by undiagnosed cardiac abnormalities. In Italy and other European countries, teen and adult athletes are screened for heart conditions before they play sports, which is an action some researcher hope will take off in the United States.
However, studies show that these screenings, like the commonly used echocardiogram (ECG), may not give researchers the answers they need.
“Doing lots of tests often comes with more questions than answers,” said Children’s National Health System’s Division Chief of Cardiology Charles I. Berul, MD. “Most kid’s ECG scans will be normal and those that are not will require more tests. Most abnormal ECGs are false positives.”
According to an article in Reuters Health
, while ECGs are inexpensive, about $10 per test, those individuals that have abnormal findings could need more testing at $2,000 per student athlete.
Dr. Berul does not think that ECGs are the best first-line test to rule out a heart problem, and they may keep young children out of sports unnecessarily (due to false-positive test results). He suggests that an athlete’s primary care physician should use a pre-participation symptom assessement as a more accurate way to screen prior to sports participation.
Dr. Berul says providers should ask about behavior and family history, with questions like:
- Have you ever fainted during exercise?
- Have you ever fainted after exercising?
- Have you ever had extreme shortness of breath during exercise?
- Are there any family members who died suddenly and unexpectedly before age 50?
- Are there any family members who died suddenly of “heart problems” before age 50?
- Are there any family members who have had unexplained fainting or seizures?
If a child's history or family history shows an increased risk, then further testing would be needed.
“There needs to be a better test. At this time there is not a great test to rule in or rule out the susceptibility of heart problem,” Dr. Berul said.
So, as parents of athletes, what do you think? Does your child's doctor ask any of these questions?