Hidden Heart Problems for College Athletes

Because of the large margin for interpretation on what constitutes an "abnormal" ECG, some experts believe that screening college athletes universally would lead to too many young people undergoing unnecessary further testing -- and more importantly, would put them through unnecessary stress and worry over the possibility of having a life-threatening heart condition.

"Depending on where you decide to set the bar for what an 'abnormal' ECG is, you could generate much more unnecessary testing ? and would impart more worries [for the patients], more concerns [and would] complicate their health records," said Dr. Steve Ommen, professor of medicine and director of Hypertrophic Cardiomyopathy Clinic at the Mayo Clinic in Rochester, Minn.

The American Heart Association's current guidelines on screening competitive athletes for heart conditions reflect Ommen's concerns on universal ECG screening of college athletes. As it stands, the association recommends screening for any and all competitive athletes with a standard physical, a discussion with a doctor about personal and family history and having a doctor listen to your heart for a murmur.

However, the association does not recommend that all competitive athletes undergo prescreening with an ECG.

"What's a little controversial is whether competitive athletes should get a standard ECG," said Dr. Lance Becker, spokesman for the heart association and director of the Center for Resuscitation Science at the University of Pennsylvania. "The AHA [the American Heart Association] does recommend an ECG screening, but it's called a 2A recommendation, meaning it's considered an acceptable and good thing to do but not absolutely required in all cases."

"The typical reason for it being in that category is simply one of lack of research and lack of evidence," Becker said.

According to a study published in the journal Circulation in 1995, you would find one case of hypertrophic cardiomyopathy for about every 500 people screened. Some experts said the prevalence of this disease is simply much too low to justify universal screening.

"Every death is a tragedy, but to find those deaths is [like finding] a needle in a haystack, and ... when looking for a needle in a haystack you find a lot of hay," said Dr. Paul Thompson, chief of cardiology and director of the Preventive Cardiology Program and of Cardiovascular Research at Hartford Hospital in Hartford, Conn.

Other experts cited the enormous cost and manpower required to conduct and interpret all of the ECGs as an argument against universal screening for competitive athletes.

"There are not enough cardiologists nationwide to interpret all of the ECGs that would be required for every high school, high school and collegiate athlete, [and] if these are then interpreted by less skilled internists or family doctors, there will be an increase in false positive and false negative readings," said Dr. Robert Bonow, chief of the Division of Cardiology and co-director of the Bluhm Cardiovascular Institute at the Northwestern Memorial Hospital in Chicago.

"This is why this remains controversial and why the medical societies have not recommended widespread screening beyond family history and heart murmurs on physical exam," Bonow said.

Sidelined, but Not Out of the Game

Because of the screening Cherry underwent before competing with the Eagles, he was able to identify and treat his heart condition before the ticking time bomb exploded.

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