Source: Indys Child Parenting Magazine

Heart Screenings for Young Athletes
An Simple Precaution with Lifesaving Implications

by Dr. Randall Caldwell

October 01, 2010

It seems unthinkable: A healthy-looking young athlete suddenly dies during practice or competition. Even though these shocking deaths make headlines, the incidents are fairly rare. However, as a parent, you want to arm yourself with the right information as your child heads to the doctor’s office for that all-important sports physical.

What is sudden cardiac death?

Sudden cardiac death in young athletes is mostly likely caused by a heart problem that may not have been detected before and occurs without warning. Athletes appear to be more vulnerable than other young people because of the adrenaline rush they experience while playing sports. There are several underlying conditions that can trigger heart failure during training or competition.

Sudden cardiac death appears to be more common in boys, African-Americans, and football and basketball players. Researchers have yet to discover why more cardiac-related deaths are associated with those two sports, but one reason might be the sheer numbers of players: Football and basketball are the most prevalent youth sports in America today.

Sports physicals

In order to participate in many organized sports activities, children and teens need a yearly physical exam. As part of your child’s sports physical, the doctor will conduct a thorough examination that includes blood pressure measurements. He or she also will likely obtain a detailed history of any personal or family heart conditions. Further screening may be needed if there is a history of chest pain, dizziness or fainting; abnormal shortness of breath or fatigue during exercise; a family history of unexpected sudden death within the family; or a history of abnormal heartbeat or heart murmur. Additional screening also may be necessary if your child is unusually tall and is experiencing heart or eye problems.

The most common cause of sudden cardiac death is hypertrophic obstructive cardiomyopathy (HOCM), a birth defect that causes excessive thickening of the heart muscle and impairs blood flow. It can often be detected by an echocardiogram (ECHO) or cardiac ultrasound exam. This is a quick and easy test that takes "moving pictures" of the heart and allows doctors to determine if there is a problem such as a heart murmur or a congenital heart defect. An Italian study over a 25-year period also documented an 89 percent decrease in the incidence of sudden death in athletes by adding an electrocardiogram (ECG) to a careful history and physical.

Signs and symptoms

Many people with HOCM experience no symptoms, while others may experience notable signs. Some of these signs may include:

• Chest pain or pressure that usually occurs with exercise or physical activity

• Shortness of breath and fatigue during exercise

• Fainting or passing out

• Heart palpitations, like a fluttering of the heart

If your child is diagnosed with a heart problem, you, your child and your child’s doctor will make the decision about future physical activity and sports. The good news is that the majority of young athletes with heart conditions can participate in most, if not all, physical activities.

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Dr. Randall Caldwell is director of Pediatric Cardiology, Riley Hospital for Children