Sports physicals with cardiac testing make a difference

 

We’ve all heard the terrible stories – a seemingly healthy young high school athlete suddenly dies.  Although rare, these tragic occurrences can be caused by unrecognized congenital cardiovascular conditions such as hypertrophic cardiomyopathy and long QT syndrome. 

 

Hypertrophic cardiomyopathy is the most common cause of nontraumatic sudden death in young athletes.¹ It is characterized by an abnormal thickening of the wall that separates the two main pumping chambers of the heart and occurs in about one in 500 people in the general population.² The danger is that any physical exertion may generate a ‘short circuit’ and the heart will stop.

 

A routine physical that includes an electrocardiogram (ECG) may prevent such tragedies.

 

Simple but effective

An ECG exam can help detect heart conditions that account for up to 60 percent of sudden cardiac deaths in young athletes.³

 

ECGs record the electrical signal from the heart. It is performed by placing electrodes on the chest, wrists and ankles.  In hypertrophic cardiomyopathy, the ECG usually shows an abnormal electrical signal due to the muscle thickening and disorganization of the muscle structure.  The exam is quick, painless, easy to read and easy to administer.

 

So why isn’t it offered more commonly to young people?

 

Getting Tested

Typically people under the age of 40 aren’t prescribed an ECG exam.  It’s been thought healthy youngsters don’t need it.  Dr. Paul Steingard disagrees, "Too many student athletes are dying from cardiac conditions that are detectable and treatable."

 

Dr. Steingard, a former team physician for the Phoenix Suns basketball team, knows that the exams professional athletes are given can catch unseen cardiac problems.  These more rigorous exams include blood work, chest X-rays and ECGs.  Based on this knowledge, Dr. Steingard founded TOPS (Team of Physicians for Students).  With the help of cardiologist Dr. W.J. Rappoport, TOPS now administers free physicals to Arizona high school athletes that include cardiac testing using ECG and echocardiography (Ultrasound).

 

Their success is dramatic - on April 22, 2006, 2,540 ECGs were performed in a single day session.

 

What’s an echocardiogram? Echocardiograms are sometimes used as a followup to ECG studies. But What is Echocardiography and how does it work?   + View Exam Guide

 

Playing it safe

The TOPS evaluation includes a detailed personal and family history, physical exam and ECG.  If any abnormality is present in any area, an echocardiogram is obtained for confirmation. 

 

Students with abnormal ECGs, heart murmurs, and high blood pressure are restricted from team activities and sent home with referral to family doctors and specialists.

 

It is hoped that free sports physicals with cardiac testing will not only help save athletes lives, but demonstrate that unseen cardiovascular problems can be diagnosed and treated before it’s too late.

 

“We want to help reduce the risk of sudden death in young athletes and to raise awareness around this significant and sometimes overlooked issue,” concludes Dr. Steingard.

 

- August 2007

 

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