Heart screening for athletes reduces sudden deaths

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A study by Italian cardiology researchers has shown that a pre-participation cardiovascular screening program that spots hidden heart trouble can significantly reduce the rate of sudden death in athletes.

The majority of young athletes who die suddenly have previously unsuspected structural heart disease and the researchers say that by screening athletes for cardiomyopathies, abnormalities of heart muscle which can cause sudden death, lives have been saved.

A national screening program was launched in Italy in 1982, which includes a detailed history, physical examination, and an electrocardiogram (ECG); the program has been shown to be effective in identifying athletes with certain heart disorders.

However, the long-term impact of such a screening program on prevention of sudden cardiovascular death in athletes has not been known.

For the study Domenico Corrado, M.D., Ph.D., of the University of Padua Medical School, Italy and colleagues analyzed the changes in incidence rates and causes of sudden cardiovascular death in young athletes, age 12 to 35 years, in the Veneto region of Italy between 1979 and 2004, following the introduction of systematic pre-participation screening.

The researchers found that by 2004, the rate of sudden cardiac deaths in the Veneto section of Italy dropped by 89 percent.

The researchers say the screening program also led to 2 percent of the athletes being disqualified for competition for medical reasons.

Experts in the U.S. estimate that each year from 200 to 400 young athletes die on the playing field from cardiac arrest.

The American Heart Association recommends screening for high school and college athletes before they compete, including a physical examination plus a family history which is important because many cardiomyopathies are inherited.

European authorities also recommend that potential athletes undergo electrocardiogram (ECG).

However, American sports organizations have not as yet called for ECG screening, on the grounds that many young people are wrongfully identified as having problems on the basis of an ECG.

Many experts disagree with that assessment and say every young athlete should be thoroughly screened for heart problems by a trained health-care provider as detecting abnormalities can save lives and also help young people identify and treat potential problems early.

The Italian team believe that screening athletes for cardiomyopathies is a life-saving strategy and ECG’s are a powerful tool in detecting such abnormalities.

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