Reuters is reporting research from Italy claiming that mandatory heart screenings for all athletes could detect potentially fatal problems and save lives. The findings, published in the British Medical Journal, suggest that a family history and physical exam miss many undiagnosed heart problems.
Unlike in the U.S.., competitive athletes in Italy have to have two electrocardiogram (ECG) heart tests, one at rest and one during exercise, before they can enter a sport. This review, of 30,065 athletes over a 5-year period, found that the tests detected a number of silent heart problems.
The resting ECG found that 1.2% had abnormal test results and the ECG during exercise detected problems in nearly 5%. Of the 159 people eventually disqualified due to heart problems, only 6 would have been picked up through medical history and physical exam alone, which is the current U.S. standard.
The risk is not just for top athletes either. Figures show one young athlete dies every three days from an unrecognized heart problem in the United States alone.
These result clearly bolster arguments that the heart tests should be mandatory in other countries.
However, the the American Heart Association disagrees. In 2007, the AHA reaffirmed their recommendation against universal use of electrocardiography, citing cost, low prevalence of disease, and a high false positive rate.
Nevertheless, the European Society of Cardiology, the International Olympic Committee, and other sports league endorse the screenings. My vote is with this group.
And, pity the physician who approves a kid for competitive sports who has a cardiac related death and who has not had these screening tests – especially if the family contacts an attorney aware of this Italian study.