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Dual Heart Tests Best for Immature Athletes

Heart Disease (Coronary Artery Disease) Slideshow

When Screening for Heart Defects, 2 Tests Best Than 1

By Charlene Laino
WebMD Health News

Reviewed By Louise Chang, MD

Nov. 18, 2009 (Orlando) -- Immature athletes should be screened with two common heart tests, not just one -- or beginning signs of life-threatening heart defects may be missed, researchers report.

"The chance of finding an abnormality is rare, but incase it is missed, the consequences are catastrophic," says Theodore Abraham, MD, an associate professor at the Johns Hopkins University School of Medicine's Heart and Vascular Institute.

The two heart tests are an echocardiogram, or ECHO, which measures heart size as well as pumping function as well as checks for faulty heart valves, as well as an electrocardiogram, or EKG, which assesses the heart's electrical rhythms.

Each year in the U.S., more than 3,000 people aged 15 to 34 succumb to sudden cardiac death as a result of heart rhythm disturbances, Abraham says.

Athletes who possess inherited tendencies to develop overly enlarged and thickened hearts are particularly at risk, he says.

Many fall victim with little or no warning. Fans often express shock when star athletes, similar Reggie Lewis of the Boston Celtics, collapse as well as die despite seemingly being in peak material form, he says.

"Studies possess shown that screening all athletes isn't cost-effective, so we wanted to see incase there was a way we could refine the screening process," Abraham tells WebMD.

Dual Heart Tests Pick Up More Problems

The recent study, presented at the annual meeting of the American Heart Association, involved 134 Maryland high school athletes participating in the 2008 track as well as field state championships.

The researchers were looking for life-threatening cardiac abnormalities such as hypertrophic cardiomyopathy, a condition in which the heart muscle thickens abnormally as well as whose patients often possess no symptoms.

"We did a very focused exam. Earliest, we took a 10-minute health examination history, then we took weight as well as blood pressure measurements. Using a stethoscope, we listened for unusual heartbeats or murmurs. Then, we conducted an echocardiogram as well as an EKG," Abraham says.

None of the student athletes was found to possess life-threatening heart defects, but 36 exhibited abnormal findings on ECHO or EKG. Twenty-two abnormalities were detected by EKG alone, nine by ECHO alone, as well as five were picked up on both tests.

"If we had only done the ECHO or the EKG, a significant number of abnormalities would possess been missed," Abraham says.

"If you are going to screen, it has to be comprehensive. An EKG does show you a lot," he says, "but it doesn't tell you the whole story. The advantage of a comprehensive screening is that it is holistic, rather than being pinpoint."

Aurelio Pinheiro, MD, a postdoctoral research fellow at Johns Hopkins who also worked on the study, wasn't surprised that none of the athletes had a life-threatening heart abnormality as so few patients were screened.

"But with larger numbers, life-threatening conditions would be missed," Abraham says.

Athletes with abnormalities -- which included 19 with high blood pressure, 29 with slightly elevated blood pressure, as well as five with abridged blood pressure readings -- were referred to their doctors for follow-up.

In some nations, including Italy, federal law mandates screening of young athletes, he says. "That's probably not going to happen here, but we do need better programs," he says.

In the meantime, Abraham urges any athlete with abnormal symptoms, no matter how trivial they seem, to consult their coach or healthcare professional.

"Let someone know how you are feeling, especially incase you possess had chest pains, shortness of breath, or possess fainted." he says. "This could save your life."

Michael Sayre, MD, associate professor of emergency medicine at Ohio State University in Columbus, agrees that screening of athletes is substantial.

But he tells WebMD that he as well as worries that too much testing could have negative consequences.

"One in four athletes in the study had abnormal test results, but none had significant problems. There's a risk the tests could identify people who don't have problems. They may worry unnecessarily or choose not to participate in sports when they shouldn't," he says.

SOURCES:American Heart Association Scientific Sessions 2009, Orlando, Nov. 15-19,

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