Heart Check May Save Athletes' Lives

Young athletes may benefit from mandatory heart checkups to gauge their risk of sudden cardiac death.

That's what Italian doctors report in The Journal of the American Medical Association.

But exactly what type of heart screening young athletes need is still debatable, according to an editorial published in the journal.

Young athletes may appear to be the picture of health, but in rare cases, they're vulnerable to sudden cardiac death due to heart abnormalities.

The American Heart Association recommends heart screening for high school and college students before they start participating in athletics. That guideline includes personal and family medical history, but it doesn't call for routine electrocardiograms (ECG or EKG).

But in Italy's Veneto region, ECG heart screening became mandatory in 1982 for all would-be athletes aged 12-35.

In an ECG, doctors place electrodes on different areas of the body to take a snapshot of the heart's electrical activity. This information can be used to help diagnose heart disease.

Checking Up on Heart Checkups

Did mandatory ECGs curb sudden cardiac death in young Italian athletes? That's the question asked by the University of Padua's Domenico Corrado, MD, PhD, and colleagues.

They checked data on sudden cardiac deaths in athletes aged 12-35 in Veneto from 1979 to 2004.

During that time, sudden cardiac death struck 55 young athletes in Veneto.

After the ECG heart checkups became mandatory, sudden cardiac death among young Veneto athletes dropped 89%, the researchers report.

They found no such drop in sudden cardiac deaths among unscreened, nonathletic Veneto youths.

Those results are "provocative," write the editorialists. They included Paul Thompson, MD, of the cardiology division at Hartford Hospital in Hartford, Conn.

But Thompson and colleagues aren't ready to require ECGs for all young athletes.

The Italian study didn't show whether heart checkups without ECGs would also have prevented sudden cardiac death, the editorialists note.

They also point out that Veneto's sudden cardiac death rate before mandatory testing was high -- one death per 27,777 athletes in 1979-1980 compared with rates reported from other studies.

Veneto's lowest rate of sudden cardiac death was similar to the 1983-1993 rate for U.S. high school and college athletes who didn't get mandatory ECG testing, the editorialists note.

In short, the editorialists and the Italian researchers both support heart checkups for would-be high school and college athletes. But they disagree about whether the Italian strategy -- which requires ECG tests -- is the way to go.

SOURCES: Corrado, D. The Journal of the American Medical Association, Oct. 4, 2006; vol 296: pp 1593-1601. Thompson, P. The Journal of the American Medical Association, Oct. 4, 2006; vol 296: pp 1648-1650. News release, JAMA/Archives.