Most young athletes who die suddenly from apparent heart problems would not be saved by heart checks, a new study suggests.
To assess the need for checks, researchers from the Hypertrophic Cardiomyopathy Centre at the Minneapolis Heart Institute Foundation in Minneapolis looked at the case records of the US National Registry of Sudden Death in Athletes from 1986 to 2011 to identify deaths thought to be heart related occurring in organised competitive interschool sports in Minnesota.
Amongst 1,930,504 individuals taking part in 24 sports (4.44m participations) there were 13 incidences of sudden deaths related to physical exertion during competition (7) or practice (6). The ages were 12 to18 and each was a white male. Most common sports involved were basketball, wrestling or cross-country running. Sudden deaths occurred in one out of 150,000 participants.
In autopsy documents Dr Barry Maron and his colleagues found there were cardiac causes in only 7 of the 13 deaths. In only four athletes, the responsible heart disease could be reliably detected by history, physical exam or 12-lead ECG.
The research was presented at the weekend at the American College of Cardiology Scientific Sessions.
Currently, athletes are assessed through a physical exam and reviewing their clinical history.
Dr Maron said: "This is a controversial issue because some are suggesting that all young competitive athletes should be screened with a 12-lead ECG screening, which would be a massive and costly undertaking. Also, we do not have any evidence to show whether this is clinically necessary," he added.
"This very low event rate does not warrant changing the current national screening strategy, especially because only one-third of the deaths would have been detectable through additional screening," said Dr Maron.
"These findings demonstrate that these tragic events are rare. In addition to these data, no evidence in the medical literature has shown that ECGs reduce mortality in a broad-based screening effort," he added.
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