Sunday, March 6, 2011

Sudden Death In High School Athletes: Is It Time For Routine EKGs

The deaths of teenage basketball Star West Leonard closely followed by 17-year-old rugby player Matthew Hammerdorfer have raised a very reasonable question, "just how often do tragedies like this strike". According to the journal Circulation, the Journal of the American Heart Association, the rate of sudden cardiac deaths in young athletes was similar to that of deaths from lightning. But even though they are rare they are hard-hitting and have tremendous impact. The two primary causes of sudden death from heart conditions in which there were no previous symptoms are hypertrophic cardiomyopathy and a genetic condition called long  QT syndrome. Hypertrophic cardiomyopathy is a thickening of the heart muscle and  can cause cardiac arrest during exertion.  The QT syndrome is a problem with electrical regulation of the heart. It is very difficult to detect these underlying heart conditions but a physical examination. EKGs can help but in the United States they are not recommended because testing is costly and can lead to false positive results which would mean unnecessary additional testing. There are many cardiologists who believe the EKGs should be standard. The European Society of cardiology recommends routine EKGs. One of the best ways to screen is through pointed questions for instance does the child have heart palpitations, a racing heart or passes out. Sadly the first warning in many of these cases is the sudden cardiac event while participating in a sports related activity.

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