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Heart health risks in teen athletes

Millions of students participate in sports activities at high schools and colleges across the country. Every year, some of those athletes die while playing on the field or court.

Doctors say exercise increases the risk of dying from a cardiovascular abnormality by two to three times.

Shortness of breath, feeling dizzy and a hard heartbeat are some of the warning signs of sudden cardiac death.

Dr. David Price is the medical director of the Heart of a Champion Day Program at Carolinas Medical Center in Charlotte, North Carolina.  

"I think the prevalence is a lot more than we thought," Price says.  

When sudden cardiac arrest occurs in a young person, it usually stems from a structural defect in their heart or a problem with the its electrical circuitry.

Usually, no one knows about the abnormality until the child becomes a teen and starts playing a sport that gets their heart pumping hard.

"They make a big basket, they're walking away and all of a sudden, their heart flow gets disrupted, it causes this arrhythmia and two to three seconds later, they pass out," Price says. 

Of the 1,500 athletes screened for heart problems annually, a few are sent for further testing and one or two are sidelined indefinitely because of a defect that could kill them.

Their lives may be saved, but their activities are forever changed. As a result, these teens must not engage in activities that will get their heart rate up, but Price says the health risk still exists.

If your area doesn't offer a similar screening program, Price recommends athletes add an Echocardiogram or EKG to their sports physical.

Price says the results must then be interpreted by a physician who is familiar with EKG's performed on athletes.

That's because hard exercise develops a young heart and the small changes that will show on the EKG can easily be misread by an inexperienced eye.  

According to the American Heart Association, there is no nationally-accepted standard for screening athletes before they are allowed to participate in sports.

Due to medical costs, false alarms and lack of evidence that EKG and echo screening reduces the number of deaths, experts recommend athletes stick to a personal and family history assessment and a physical exam designed to identify cardio issues before a youth athlete hits the field or court.

Parents should also go to their teen's physical screening to ensure doctors know about the family's medical history, and to ensure a teen doesn't omit critical health information that could prohibit him or her from playing.

Another thing you should do is learn CPR and find out if your sporting areas have automated external defibrillators and trained staff.

If your child's physical or exam is held inside a gym, you may want to schedule a solo screening with your doctor. Otherwise, the noisy environment could make it extremely difficult for a doctor to hear the slight irregularities in your child's heart beat.

Copyright 2013 America Now. All rights reserved.

Additional Information

Dr. David Price works in Sports Medicine at Carolinas Medical Center in Charlotte, NC. He is also the medical director of the "Heart of A Champion" program.

  • Unlike other countries, the U.S. does not have a national registry to report teen athlete deaths making it hard to keep track of the actual number of student deaths.
  • Exercise increases a teen's chances of dying of a heart issue by about 2-3 times.
  • The "Heart of a Champion" program uses both electrocardiogram and echocardiogram (ultrasound) to look at the rhythm and structure of the heart.
  • The program is free to students.
  • If an abnormality is found, students are sent to a cardiologist to confirm with a full heart evaluation.

The following information was obtained from the American Medical Association regarding the lack of standardized screening (Source: http://www.ama-assn.org/amednews/2011/11/21/hlsa1121.htm).

  • As the medical community considers requiring electrocardiograms, echocardiograms or other tests for all athletes, some physicians argue that the focus first should be on implementing uniform standards and reporting methods nationwide.
  • There is no mandatory reporting system for these deaths so studies range. One in every 30,000 to 200,000 U.S. high school athletes die annually from sudden cardiac arrest.
  • Some worry that the wide variety of practitioners performing student exams, inhibits uniformity (internists, pediatricians, family physicians, physician assistants or nurse practitioners). Different protocols state to state, doctor to doctor and school to school can be a problem.
  • Mass physicals in gyms may create an environment where a doctor can't even hear the warning signs of an irregular heartbeat.
  • Parents should be present since most students do not know their family history. Or, students might withhold information if they think it will keep them off the field.

The following information is from a NYTimes.com article regarding sudden cardiac death in athletes (Source: http://well.blogs.nytimes.com/2012/04/30/heart-risk-in-athletes-is-gaining-attention/).