Does Your Teen Athlete Need a Heart Test?
Consider a heart checkup so your child doesn’t miss a beat in their favorite sport
Last year, 14-year-old Emily Orta collapsed on a soccer field from sudden cardiac arrest. First responders saved the Michigan girl’s life, but other teen athletes aren’t so lucky.
Each year, about 100 high school or college athletes die from sudden cardiac arrest, which can be caused by a variety of heart conditions.
Sudden cardiac arrest on the sports field can occur in kids who had no previous symptoms, says Ismael Gonzalez Rangel, MD, a pediatric cardiologist at Beaumont Health System in Michigan.
“Sometimes, the first symptom is sudden death,” he says.
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How teen athlete heart clinics work
Clinics offer free or discounted heart screening to teen athletes, often as part of outreach programs by hospitals. Health care professionals in these clinics may take a heart health history and do an electrocardiogram (ECG) — a test that checks the electrical activity in the heart — and an echocardiogram, a type of ultrasound that looks at the structure of the heart.
These tests can find heart problems that are common culprits sudden cardiac death, Gonzalez Rangel says. For example, tests might spot:
- Hypertrophic cardiomyopathy. This is a condition in which a thickened heart muscle makes it harder for the heart to pump blood, Gonzalez Rangel says. The disease may affect one in 500 people, he notes. “We’re talking about a lot of people.”
- Anomalous origin of coronary artery. This happens when a coronary artery is coming from the wrong part of the heart. When the left coronary artery is coming from the right cusp of the heart, the artery can get compressed during exercise, Gonzalez Rangel says.
- Heart arrhythmias. Various types of heart rhythm problems also can cause sudden cardiac death.
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If a problem is diagnosed, treatment may be necessary, Gonzalez Rangel says. Depending on the condition and severity, some patients might need surgery, medication or monitoring.
Each year, through this type of screening, Gonzalez Rangel and his colleagues catch two or three previously undiagnosed heart problems, he says. “If we can save one life a year, it’s worth it."
Should your teen get a heart test?
Doctors and other experts are divided on whether heart screening with ECGs and echocardiograms should be standard for teen athletes. The American Heart Association (AHA) says no, and instead recommends that all teen athletes get a 12-point cardiovascular screening that includes a personal heart history, a family history, a physical exam and blood pressure and heart murmur checks.
Teens with red flags found during that basic screening may need an ECG or other further screening, according to AHA.
If you’re a parent of a teen, here are four things you should know about teen athletes and heart tests:
1. Sudden cardiac death in teen athletes is rare. The number of high school athletes who suffer sudden cardiac death ranges from one in 23,000 to one in 300,000, according to the AHA. And it’s relatively uncommon for teens to have heart conditions that put them at risk for sudden death, according to the AHA. That’s one reason some experts say it doesn’t make sense for all teen athletes to get ECGs and other tests.
2. The problem goes beyond teen athletes. Teen athletes might make headlines when they collapse and die on the court, field or track, but other kids suffer sudden cardiac death too, Gonzalez Rangel says. In fact, only about 25 percent of cases happen during sports. “Some kids die at home and don’t make the news,” he says, adding that he believes all kids over 12 should get screening.
3. Most teens don’t even get basic heart screening before playing sports. One AHA survey of doctors who do prescreening of teens for competitive sports found less than 6 percent of doctors provide the basic AHA-recommended screening as part of their physicals.
4. There may be downsides to teen athlete heart clinics, according to some experts. First, providing health care outside of a health care system potentially can cause problems, says Lisa Salberg, founder and CEO of the Hypertrophic Cardiomyopathy Association. For example, records from heart tests done in a clinic often don’t make it to the child’s regular doctor, she says. “Systems provide the most continuity, and continuity of care is critical,” she says.
Finally, some problems can be missed or show up after testing, so getting the all-clear at a clinic doesn’t mean everything’s OK, Salberg says. “The test might give you a false sense of security.”
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