This post is for the parents out there. I don’t have many youth athlete readers here at the blog, but I’ll bet there are more than a few parents.
We’re all familiar with the sad stories of young athletes who die suddenly while playing their sports. According to most estimates, about 1 young athlete per 50,000 to 100,000 per year will have sudden cardiac death during practice or competition. These incidents often receive a great deal of attention in the media. They also have a lasting impact on families, schools, and communities that struggle afterwards to deal with the tragedy.
The medical community also struggles with this issue. There are very legitimate differences of opinion about what best to do. We know that most of these young athletes die from some sort of unrecognized heart problem, so there’s an obvious motivation for cardiac screening programs to find these heart problems before a young athlete dies as a result. Yet we also know that such screening programs are costly in both monetary terms and in the needed resources. We also know they’re not foolproof.
In last week’s November 21, 2013 edition of the New England Journal of Medicine, a Clinical Decisions feature was devoted to the topic of “Cardiac Screening before Participation in Sports,” focusing on school-aged athletes. This feature asked experts in the field to respond to 2 related questions.
The first question asked: Should young athletes be required to undergo cardiac screening before participating in sports?
- Dr. Sanjay Sharma, a cardiologist from the St. George’s University of London answered YES.
- Dr. Mark Estes, a cardiologist from Tufts University in Boston answered NO.
The second question asked: If an athlete does undergo screening, should the screening involve only a history and physical examination, or should electrocardiography (ECG) also be required?
- Dr. Victoria Vetter, a pediatric cardiologist from Children’s Hospital in Philadelphia, recommended AGAINST the ECG.
- Dr. Domenico Corrado, a cardiologist from the University of Padua in Italy advocated FOR the ECG.
The position statements are intended for a physician audience, but even non-medical folks will be able to read them and learn something. Take a moment to read what these doctors say. In just a few short paragraphs, each summarizes the important arguments. You won’t find a better summary of the arguments.
The journal also has an online poll for readers to weigh in on the issue. The poll asks readers to consider the expert opinions and then answer the 2 questions for themselves. I answered YES for screening and YES for an ECG. As I sit here writing on Sunday afternoon, nearly 900 readers have responded to the poll, with the following results:
- 18% voted for requiring NO screening
- 23% voted for screening with medical history and physical examination alone
- 57% voted for screening that also included an ECG.
At the level of schools, communities, and states, there is increasing awareness about the issues surrounding cardiac screening for young athletes. Some have created screening programs that are available to athletes, often at little or no cost. In the end, though, in most communities parents will need to make appropriate decisions about cardiac screening for their children. Be informed.