Heart Screening & Your Young Athlete

Recent news about instances of heart defects in top teen athletes has brought into focus the debate over heart screening for high school players. Currently, most student athletes are required to get a routine physical at the beginning of the season. This standard physical exam doesn’t normally include a electrocardiogram (ECG) that can detect signs of irregular heart rhythms and other dangerous heart defect markers. Note: The ECG doesn’t catch every damaged or potentially defective heart either.

Here’s a good place to start to learn what to look for in your young athlete and then follow-up with a physician, or healthcare professional.

“Currently, the American Heart Association’s 12-point screening program for identifying athletes at risk of sudden cardiac arrest relies on a physical exam and a careful interview designed to uncover signs of heart problems in both the teen and her family. Teens are asked if they’ve ever fainted or had chest pain or fatigue associated with exercise. Then they are asked whether anyone in the family was disabled or died of heart disease before age 50.

In a physical exam, doctors look for heart murmurs, problems with the artery leading away from the heart, and signs of Marfan syndrome, a condition that leads to tall stature as well as weakening of the heart’s major arteries.

The Heart Association doesn’t recommend that every high school athlete get ECGs because of problems with the test and because of the high cost of screening so many students, said Dr. Stephen Daniels, a spokesman for the association and chair of the department of pediatrics at the University of Colorado School of Medicine.”

*The American Heart Association

Chest pain/discomfort upon exertion
Unexplained fainting or near-fainting
Excessive and unexplained fatigue associated with exercise
Heart murmur
High blood pressure
One or more relatives who died of heart disease (sudden/unexpected or otherwise) before age 50
Close relative under age 50 with disability from heart disease
Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy in which the heart cavity or wall becomes enlarged, long QT syndrome which affects the heart’s electrical rhythm, Marfan syndrome in which the walls of the heart’s major arteries are weakened, or clinically important arrhythmias or heart rhythms.
Femoral pulses to exclude narrowing of the aorta
Physical appearance of Marfan syndrome
Heart murmur
Brachial artery blood pressure (taken in a sitting position)
If individual has been restricted from participation in sports in the past
If individual has had prior testing for the heart, ordered by a health care provider