The American Heart Association and the American College of Cardiology have released a statement saying that a 14-point checklist should be used by doctors first before prescribing an electrocardiogram screening for young athletes. This is in line with the growing concern for sudden cardiac death in young athletes prompting frenzy for ECG tests.
According to the writing panel from AHA and ACC, it has not been proven that sudden cardiac arrests are more prevalent in athletes compared to the general population aged between 12 and 25. The panel is concerned that growing media coverage involving sudden cardiac death is promoting the idea that young athletes are more susceptible to sudden cardiac death than their peers.
The panel further adds that only when a young individual is positive for at least one item on the checklist should an ECG test be scheduled to facilitate further screening. Using an ECG for an initial screening is costly given that it does not contribute towards saving lives.
What's worse is that results from an ECG test used for initial screening may result in false-positives and false-negatives, prompting further tests that are unnecessary or completely missing genetic or congenital heart disease which could be very dangerous.
Twelve-lead ECGs work by recording the heart's electrical activity. Because of this, it can detect congenital heart disease, a precursor to sudden cardiac death. By catching hints of congenital heart disease, a 12-lead ECG warns about the possibility of sudden cardiac death.
It's understandable why there are calls for mandatory ECG testing for athletes but the fact remains that athletic youths are no more at risk than their non-athletic counterparts. Not to mention that there are more non-athletic youths in the country, with only 30 percent of students in high school and one percent of college students engaging in competitive sports.
Cost is also a concern. Although athletes represent a small portion of the general youth population, a mandatory screening program would still require at least $2 billion on its first year before overall costs taper off annually.
The 14-point checklist to be used before recommending an ECG include items like: chest pains related to exertion; inexplicable fainting; unexplained fatigue or palpitations when exercising; elevated levels of systemic blood pressure; prior heart tests as requested by a healthcare provider; prior restriction from sports; a history of premature deaths in the family before age 50 associated with heart disease; specific knowledge that family members have certain heart conditions; heart murmurs detected upon examination; and physical signs of Marfan syndrome upon examination.
The statement was published in the Journal of the American College of Cardiology and AHA's Circulation.
