May 4, 2012

When Are Heart Screenings for Athletes Recommended? Children's Health Dallas expert discusses when heart screenings for athletes are recommended.

Each year 10 million to 12 million kids in the U.S. participate in sports. Statistics show that hundreds of children collapse while playing sports every year, and most of those cases involve some type of underlying, previously undiagnosed heart condition.

Sudden cardiac death occurs in one child per 100,000 each year. Ninety percent of these sudden deaths occur immediately post training or during competition with football and basketball having the highest incidence.

If your child plays sports, do you need to take precautions?

Heart Screenings

Dr. Michael Day
Dr. Michael Day

To prevent an unexpected collapse, Dr. Michael Day, a cardiologist at Children's Medical Center recommends that every young athlete should undergo a thorough evaluation.

Before heading to the practice field, a careful history and physical by a primary care doctor focusing on exercise-induced symptoms, family history and cardiac exam and vital signs should be performed as a precautionary measure," Dr. Day said.

Strenuous physical activity is thought to trigger cardiac episodes. Most collapses occur suddenly, but there can be observable warning signs. Studies show that about half of pediatric patients who succumb to sudden cardiac death had experienced a warning sign. Heart screenings for athletes are recommended when any of the following conditions occur:

  • Exercise-induced symptoms such as difficulty breathing during exertion
  • Chest pain
  • Fast or irregular heartbeats
  • Fainting during exertion
  • Excessive fatigue
  • Resting tachycardia (rapid heart rate in an inactive or sleeping individual)
  • Resting hypertension (elevated blood pressure in an inactive or sleeping individual)
  • Family history of sudden cardiac death or enlarged or thickened heart in young family members
  • New onset of a heart murmur in an adolescent
  • Excessive parental/child anxiety or stress

The most comprehensive cardiac evaluations for young athletes include a resting electrocardiogram (ECG), 24-hour ECG monitoring, exercise stress testing, an echocardiogram or combinations of all of these procedures. But Dr. Day says that most parents should not worry because the conditions which cause sudden cardiac death are rare, especially for children. In fact, a teen is about 500 times more likely to die in a car accident than while playing sports.

Sudden Cardiac Arrest

Sudden cardiac arrest occurs when the heart abruptly stops beating. In these incidents, the person may stop breathing, become unresponsive and exhibit no detectable pulse. Unlike a heart attack, where a loss of blood supply causes the heart muscle to become dysfunctional, a sudden cardiac arrest occurs when the heart's electrical system fails. Impulses to the heart are not able to form an organized beat, which may cause the heart to beat erratically or stop altogether.