Keep the rhythm of their active hearts beating and consider a heart screening as part of young athletes’ annual clearance for competition.
Albert Gutierrez, MD, pediatric cardiologist in Lafayette with Our Lady of Lourdes Women’s & Children’s Hospital, helps us understand why parents should consider having their student-athletes receive a heart evaluation.
One Screening Model
Most of Europe has gone to a model in which an electrocardiogram (EKG) is required for all athletes as part of the annual screening process. An EKG monitors the electric signals controlling how the heart beats and pumps blood. If the EKG is abnormal, further cardiologist clearance is sought.
Closer to home, many pediatricians and primary care physicians are aware of these findings that reduce athletes’ risk of sudden cardiac death. More and more of them are recommending the additional screening.
What a Cardiac Screening Can Reveal
Such a screening can uncover rhythm problems and specific conditions, including hypertrophic cardiomyopathy, a thickening of muscle walls and EKG changes. It’s usually genetic but can initially be totally indistinguishable from athletic heart syndrome.
Athletic heart syndrome is a normal, adaptive response in which the human heart is enlarged, and the resting heart rate is lower than normal. No treatment is necessary, but it is important to distinguish it from serious cardiac disorders.
Step by Step
The order for screening should be family history, a complete physical and then a screening EKG. If the findings are outside of the norm, such as a low heart rate, irregular heartbeat or a murmur, the next step is a cardiology consultation.
A patient’s family history of sudden death or strong coronary artery disease would also lead to a consultation with a pediatric cardiologist. Personal history warning signs can include chest pain, dizziness, fainting, heart palpitations, unusual shortness of breath, unusual fatigue and weakness.
The cardiologist will put everything together and proceed with further testing, such as a stress test, an additional EKG or Holter/telemetry monitoring. In more concerning cases, the cardiologist may want to proceed with a cardiac MRI.
A consultation does not necessarily mean the student-athlete would need to give up sports, even temporarily. It’s important to rule out conditions that can be life-threatening. Next steps could include periodic monitoring with the cardiologist.
COVID-19 and Young Athletes’ Hearts
Another time young athletes may need a cardiac screening before being cleared for participation in sports is after a COVID-19 infection, which can induce significant heart failure or cardiomyopathy. Check with your pediatrician on what screenings are recommended for your child.