EXPLORE!

eWellness: Children should be screened for the heart before playing any sports

  852 Views

Dr KK Aggarwal    16 November 2020

Sudden cardiac death among athletes is a rare but a devastating event. Most victims are usually young and, apparently healthy, but many have underlying undiagnosed heart disease.

As per American Heart Association guidelines, children and adolescents undergoing athletic training need medical clearance. Majority of sudden deaths amongst athletes are due to malignant irregularities in the heart rhythm, such as ventricular tachycardia and ventricular fibrillation. The precipitating factors can be prolonged physical training or unaccustomed athletic activities.

In athletes under the age of 35, the most common cause of death is underlying congenital heart disease and for those above the age of 35, it is the presence of blockages of the coronary arteries.

The Heart Care Foundation of India recommends that in every school/college, the attached doctor should evaluate all students with a 12 step history and examination to rule out high risk cases that need further evaluation.

The Foundation, along the lines of the European Society of Cardiology, also recommends an additional standard 12-lead ECG before a medical clearance is given for both competitive as well as recreational athletic activities.

Master athletes who are above the age of 35 will need an additional exercise testing before they can be given a clearance for athletic activity.

Diagnostic echocardiography is indicated when clinical, history and physical findings suggest possibility of structural heart diseases. Athletes on pacemakers should not engage in sports as bodily collision may damage the pacemaker system.

The 12-element AHA recommendations for pre participation cardiovascular screening of competitive athletes are as follows:

  • Exertional chest pain or discomfort
  • Unexplained syncope or near-syncope
  • Excessive exertional and unexplained dyspnea/fatigue, associated with exercise
  • Prior detection of a heart murmur
  • Raised systemic blood pressure
  • Premature death (sudden and unexpected, or otherwise) before age 50 years due to heart disease, in one relative
  • Disability due to heart disease in a close relative aged <50 years
  • Specific knowledge of some cardiac conditions in family members: hypertrophic or dilated cardiomyopathy, long-QT syndrome or other ion channelopathies, Marfan syndrome, or clinically significant arrhythmias
  • Heart murmur
  • Femoral pulses examination to exclude aortic coarctation
  • Physical features of Marfan syndrome
  • Brachial artery blood pressure (sitting position, both arms)

[Circulation. 2007;115:1643–1655]

To comment on this article,
create a free account.

Sign Up to instantly get access to 10000+ Articles & 1000+ Cases

Already registered?

Login Now

Most Popular Articles

News and Updates

eMediNexus provides latest updates on medical news, medical case studies from India. In-depth medical case studies and research designed for doctors and healthcare professionals.