Complete physical and history are the best way to identify at-risk children
issue 1 | winter 2012
When a young athlete dies from sudden cardiac arrest, it's always shocking. But it is not uncommon. "About 100 athletes a year in the United States die from sudden cardiac death, making the incidence about one in 40,000," says Mark Russell, M.D., pediatric cardiologist at C.S. Mott Children's Hospital. "However, there is no single etiology for sudden cardiac arrest, nor is there a single diagnostic test, so it's a challenging issue."
The American Heart Association recommends that children should have a thorough pre-participation physical that includes blood pressure measurement and auscultation of the heart, as well as a detailed personal and family history. Russell encourages parents and PCPs to use the medical history form from the Michigan High School Athletic Association to screen for inherited cardiac disorders like hypertrophic cardiomyopathy. Additionally, students, coaches and parents should never ignore early warning signs of cardiac problems, such as fainting, seizures and shortness of breath.
The AHA does not recommend EKGs for all student athletes, and providers at C.S. Mott Children's Hospital support this stance. "There is no evidence this process reduces deaths, and it produces numerous false positives," says Russell. "This also applies to the 'self-pay' screenings available from some healthcare providers. Parents' best bet is to work closely with their children's pediatrician."