Athletic trainers use a novel cost-effective screening method to ID athletes who may be at risk of sudden death.

Sudden cardiac death (SCD) occurs from an abrupt loss of heart function, and victims are often unaware that they are at risk. Coronary heart disease caused by blocked arteries is a common underlying cause of SCD. Cardiac rhythm disorders are also responsible for many of these deaths. These occur when electrical impulses in the heart become rapid (ventricular tachycardia) or chaotic (ventricular fibrillation), or both. Such sudden deaths in younger persons are especially perplexing.

In an encouraging study, athletic trainers in 10 Houston high schools took part in a new screening method. Using a laptop computer, the trainers performed electrocardiograms (EKGs) on 2,057 student athletes and transmitted their results to a cardiologist. They discovered abnormal EKGs in 186 of these young people.

Comment: When a young athlete dies suddenly, the tragedy affects not only the family but usually an entire community, too. Unfortunately, this is such a rare occurrence that widespread screening to detect kids at risk is expensive and puts an additional burden on an already overworked health care system. What this study suggests is that athletic trainers, coaches, nurses and even students could perform the EKG. (Combining today’s computer power with amazing software is simplifying science to a degree that – well, no longer requires an advanced degree!) At the other end of this new screening tool, cardiology fellows could read the EKG. So, this could be a very economical way to screen for hidden heart disease in young athletes.

While no one suggests sudden cardiac death would be eliminated in young athletes, researchers said the discovery of significant heart problems in this study implies that the risk could be reduced. The model, with modifications, could be applicable to school districts nationwide.

Links: If you’re a doctor, what do you ask in a preparticipation medical screening? Some official recommendations here. http://bit.ly/3OLq3Y For more information, here is an article we prepared for the American College of Cardiology. http://bit.ly/1NDGMs

Expanding athlete program to a general population of young people may ID teens at risk of sudden death.

In this Italian study, screening 2,013 people (average age 18) with a health questionnaire and 12-lead (EKG) revealed 6.9% had a family history suggesting sudden cardiac death (SCD) or a family history of a condition (hereditary cardiomyopathy). Either of these family histories indicates that the student is at greater than normal risk of SCD. Another important finding: 10.4% of those studied had a 12-lead EKG abnormality warranting further investigation. (In other words, it might not have been a big problem, but something about the analysis of their heart suggested a need for further testing.)

Comment: Italian physicians have been way ahead of the rest of the world in screening young people (especially young athletes) for undetected cardiac disease. It’s been a huge debate. Widespread preparticipation screening, for example, is demanding, expensive, and requires commitment of the medical community, schools, and government. However, the experience in Italy is encouraging. Add in the Houston study above and soon we may see fewer of those terrible moments when we lose a young person suddenly from a problem that simply went unrecognized.