The debate over screening ECGs
When my son was a teenager, he participated in several school sports, including track and field.
And it always freaked me out when I heard a news report about a young teen athlete suddenly dying on a track or a basketball court.
The stories were similar: young, seemingly healthy teenagers died because no one knew they had a problem with their hearts.
Every time I wondered if I should immediately take my son to his pediatrician and demand an (electrocardiogram) ECG to make sure his heart was OK.
I had to remind myself that these sudden deaths, although horrible and tragic, were actually very rare. I reminded myself that unnecessary screenings often delivered unlooked-for results that not only required more testing, and but were costly and increased everyone’s anxiety levels.
To date, there is no solid evidence that the benefits of screening ECGs on young athletes outweigh the risks.
Sudden cardiac death is rare in young people, and some physicians worry screening kids with no symptoms or family history of disease could do more harm than good. The tests can set off false alarms that can lead to follow-up tests and risky interventions or force some kids to quit sports unnecessarily.
The American Academy of Pediatrics (AAP) does not recommend screening ECGs.
Electrocardiography (EKGs) and echocardiography (echos) are not recommended as part of regular screening of athletes. This is because a heart problem is found very rarely.
Athletic screening (sports physicals) should be done by a health care provider with the training, medical skills, and background to obtain a detailed family history of heart disease, perform a physical exam, and recognize heart disease. Screening evaluations should include a complete medical history and physical exam, including blood pressure measurements.
AEDs (automated external defibrillators) save lives!
But sometimes a tragedy can be averted. I love the stories about a young athlete’s life being saved because the school had an AED on site, and someone who knew how to use it.
When a teenager’s heart suddenly stops it is almost always because there is an electrical problem with the heart. A defibrillator works extremely well in these cases. (Unlike when the victim is an elderly man with severe heart disease.)
The AEDS are small, portable and relatively inexpensive. They are also easy to use.
Youth sport leagues are being encouraged to adopt guidelines that ensure AEDs are on-site and readily available (within 1-3 minutes), and that coaches and other adult leaders are trained in their use.
Do you have a young athlete? Talk to the coach or a school official about whether an AED is available at the sporting venue—gym, park, stadium, pool, etc. Who is trained to use it?
Consider being trained yourself. Most CPR classes also teach the use of AEDs. I taught classes for the American Red Cross for years, and also taught people how to use the AEDs.
Related post: Learn CPR and first aid
Although AEDs are designed to be extremely user friendly and easy, when the adrenaline is flowing and people are panicking, it’s still a good idea to have some previous training.
Some communities are coming together to purchase AEDs for schools and other community buildings. A local mother is organizing such a campaign, and told her story on a recent newscast.
Her daughter Kiki McBride was a freshman at Foss High School and all-around healthy when she collapsed during basketball tryouts in November 2005. She was under cardiac arrest.
McBride believes Kiki may have had a better chance of survival had the school had immediate access to an AED. So she turned her grief into an effort to make sure what happened to Kiki won’t happen to other kids.
I wish her success.