Slightly modified EKG heart tests can help doctors accurately identify student athletes with heart problems that could lead to sudden cardiac death and should become a standard screening method in youth sports, according to a new study.
Researchers with the Cincinnati Children's Hospital Medical Center found adding a modified echo to the current practice of taking an echocardiogram can flag athletes at risk of the frightening and – until now – largely unpredictable life-threatening condition.
The findings, presented at an annual meeting of the American Society of Echocardiography, suggest the modified EKG test should become a standard precursor to youth sports, along with doctors taking a family history and conducting a general physical exam.
"EKG is a good tool, but may not be sensitive enough to catch problems that could lead to sudden death," said Dr. Michelle Grenier, a physician at the Cincinnati Children's Heart Institute and one of the study’s investigators. "We found that an abbreviated echo is a fiscally responsible addition that will yield useful information when screening student athletes for structural heart disease and cardiomyopathies – heart muscle diseases that are the major cause of sudden death in athletes."
According to Centers for Disease Control and Prevention, at least 300,000 Americans die each year from sudden cardiac death, including as many as 300 young athletes. Screening for risk among athletes is controversial because it is expensive and time consuming. But the new study indicates that a shortened echo may increase the sensitivity of finding heart defects in competitive athletes.
For the study, Grenier and colleagues recruited 85 teen athletes for a screening that included a health survey, physical exam, EKG and a 15-image, modified echo that took nine minutes to obtain. Echoes that were considered abnormal were referred for a complete echo, and analyzed by a cardiologist.
Ten of the participants had abnormal echoes and were referred for further assessment, despite having a normal family history, physical exam and EKG.
"The number of patients with asymptomatic, congenital heart disease was higher than expected, but the rate of cardiomyopathy – the main cause of sudden death in athletes – is probably closer to the published rate," says Dr. Grenier. "Our goal is to provide useful information to care providers, who may then better counsel athletes and their families on full participation in sports.
"The cost-effectiveness and impact on reducing the rate of sudden cardiac death aren't yet known, but the impact on quality of life in reassurance of cardiac health during exercise is priceless."