Has your middle or high school athlete received a cardiac screening? 

Every three days a student athlete somewhere in the United States collapses and dies due to an undetected heart problem. Sudden cardiac arrest is the leading cause of death of student athletes. If your middle or high school student is participating in competitive sports should they receive a cardiac screening? 

“I think routine cardiac screening for young athletes is important,” he said. “In my practice, I recommend a thorough history and physical exam and screening EKG for all competitive athletes starting in middle school.”

As a sports lover himself, Dr. Blair, taking care of young athletes is a natural fit. Young athletes often see him when they need clearance for sports. “A child may have a strong family history of heart disease, and a pediatrician needs assurance that this child does not have the same condition and is clear to play sports,” he said. “Sometimes a new heart murmur is heard on a sport’s physical and clearance from a cardiologist is needed.” His practice provides cardiopulmonary stress testing with a metabolic stress lab. “Ours is actually the only dedicated pediatric metabolic stress lab in Southern Arizona,” he said.

Why else might youth need testing?

“Let’s say a teenager has chest pain while running the mile in PE class. Depending on further history and physical findings on the patient, I may want him to do a stress test to evaluate this further,” Dr. Blair explained. “We obtain detailed data on a metabolic stress test, and this helps determine whether the chest pain is due to a heart problem, a lung problem (such as exercised-induced asthma), both or neither. It can be an extremely helpful test. We also do routine cardiopulmonary stress testing on many of our congenital heart disease patients. This helps us check their functional status and allows many of them to participate in sports at their own level.”

If you have a child starting competitive sports, make sure your pediatrician does a full physical screening including the American Heart Association’s 14-step screening process.

If a young person says “yes” to any of the 14 points, the AHA recommends further testing and an ECG test to cover all bases.

14-element AHA recommendations for cardiovascular screening of competitive athletes medical history

14-Step Screening Process:

• Chest pain/discomfort upon exertion

• Unexplained fainting or near-fainting

• Excessive and unexplained fatigue associated with exercise

• Heart murmur

• High blood pressure

• One or more relatives who died of heart disease (sudden/unexpected or otherwise) before age 50

• Close relative under age 50 with disability from heart disease

• Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy in which the heart cavity or wall becomes enlarged, long QT syndrome which affects the heart’s electrical rhythm, Marfan syndrome in which the walls of the heart’s major arteries are weakened, or clinically important arrhythmias or heart rhythms.

• Heart murmur

• Femoral pulses to exclude narrowing of the aorta

• Physical appearance of Marfan syndrome

• Brachial artery blood pressure (taken in a sitting position)

• If individual has been restricted from participation in sports in the past

• If individual has had prior testing for the heart, ordered by a health care provider

What else should I do?

Parent Heart Watch emphasizes awareness and prevention of sudden cardiac death in the young through cardiac screening, and also CPR training and placement of automatic external defibrillators in schools. Check with your child's school to make sure that coaches and trainers have CPR training and that there is a maintained automatic external defibrillator at the school and one that is present at all events. 

Sudden Cardiac Arrest is the leading cause of fatality on school property with a student athlete being affected approximately every three days. 

Cardiovascular disease is the second leading medical cause of death in children and adolescents in the United States.

Data estimates that 1 in 50 high schools has a sudden cardiac arrest (in a student or older person) on school grounds each year.

An estimated 14,000 children and infants die annually from SCD, according to the Heart Rhythm Society, May 2004.