Cardiac Screening for Young Athletes
February is heart health awareness month. Exercise and sports participation is known to improve heart health. Most young athletes can participate in sports without risk of problems due to heart or cardiovascular health.
Since exercise naturally leads to an increased heart rate and demand on the cardiovascular system, this may cause an athlete with a heart condition to experience sudden and devastating problems during activity. Unfortunately, approximately 1 in 80,000 high school athletes have sudden cardiac arrests (SCA), which may lead to sudden cardiac death (SCD). In most cases, the condition was not known prior to the event.
Adults typically have sudden problems due to coronary artery disease, a condition that develops over years in the vessels that provide blood to the heart. However, young athletes have problems from conditions that were present when they were born or were inherited and have not yet been diagnosed. Here are the most common conditions that affect young athletes:
anomalous coronary artery
arrhythmogenic right ventricular cardiomyopathy
idiopathic left ventricular hypertrophy
long QT syndrome
Properly timed and thorough screening can identify the conditions and prevent these situations. For athletes, screening typically occurs annually during a pre-participation physical or during a well-child visit with the pediatrician. The evaluation depends on the family providing an accurate medical and family history. In regards to heart health, here are some important items to report:
shortness of breath or other symptoms with activity
history of heart conditions
history of blood pressure abnormalities
These are “red flags” on a patient or family history that will lead a health care provider to a more extensive evaluation that may include additional testing:
chest pain, tightness, pressure or discomfort during exercise
fainting or passing out during or after exercise
heart racing or skipping beats with exercise
family history of unexpected sudden death at a young age (before the age of 50) from a heart condition or unknown cause
history of heart murmur or irregular heartbeat
There are many athletes with various heart conditions that are able to participate in various sports activities. However, each case is unique and each athlete should be treated on an individualized basis in partnership with the athlete’s medical home and a pediatric cardiologist.
Dr. Jane S. Chung is a Sports Medicine physician at Texas Scottish Rite Hospital for Children. She specializes in concussion management, return-to-play decisions and non-operative management of musculoskeletal injuries in young and growing athletes. As a board certified pediatrician with fellowship training in Sports Medicine, Dr. Chung provides comprehensive care for athletes with a particular interest in problems affecting female athletes. She completed her medical degree at St. George’s University School of Medicine. Dr. Chung completed her internship and pediatric residency training at Louisiana State University Health Sciences Center, Children’s Hospital. She completed a fellowship in Pediatric Sports Medicine at the Case Medical Center, University Hospitals Rainbow Babies and Children’s Hospital in Cleveland, Ohio. Dr. Chung is board-certified in Pediatric Medicine and Sports Medicine.