Cardiac screening before sports

Youth involvement in athletics can be rewarding and exciting. Cardiac screening guidelines are in place to keep kids safe while they are participating in sports. In the state of Texas these guidelines are governed for public schools by the UIL (University Interscholastic League). The purpose of these guidelines is to “identify through routine and systematic evaluation those individuals with clinically relevant cardiovascular abnormalities at risk for sudden cardiac death pursuant to appropriate guidance and treatment that will mitigate that risk”.

There are rare cardiac conditions that can harm children during vigorous competitive athletics. Most of the diseases involve heart muscle problems, coronary artery abnormalities, or electrical problems with the heart. The screening program focuses on 3 main areas to “catch” the problems.

The first area is personal medical history. This would include any signs or symptoms noticed by the student or by the family. Some important symptoms include: fainting during exercise, unexplained extreme exhaustion with minimal physical activity, severe chest pain brought on by exercise, and palpitations associated with exercise.

The second area is family medical history. This would include any family members with known serious cardiac conditions, family members who may have had sudden cardiac death, and any family members who died suddenly at a young age without explanation.

The third and final area covers the physical exam. The presence of a heart murmur may raise concern. Other important signs include: elevated blood pressure, an unexplained fast heart rate, other abnormal heart sounds, an irregular heart rhythm, abnormal lung sounds, and abnormal peripheral pulses.

If a concern is noted in any of these 3 areas, it is recommended to have further testing done by a pediatric cardiologist. At Pediatric Heart Specialists, this testing typically includes the following: a set of detailed vital signs, a comprehensive cardiac examination, an electrocardiogram (ECG), and a complete echocardiogram. These diagnostic tools allow us to be very accurate in the diagnosis of serious heart problems. At times further testing might be indicated in the form of a Holter or event monitor, exercise testing, and rarely cardiac catheterization or a cardiac MRI.

Our ultimate goal is to help protect young athletes. Fortunately, many times we are able to help return young athletes to the playing field with confidence and peace of mind. In those more rare circumstances where a serious problem is identified we can work together to immediately begin treatment and management strategies to keep these young athletes as safe as possible.

Michael Day, M.D.

Posted by Dr. Penn Laird Jr. in .

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