Dual Heart Tests Best for Young Athletes
When Screening for Heart Defects, 2 Tests Better Than 1
Nov. 18, 2009 (Orlando) -- Young athletes should be screened with two common
heart tests, not just one -- or early signs of life-threatening heart defects
may be missed, researchers report.
"The chance of finding an abnormality is rare, but if 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
The two heart tests are an echocardiogram, or ECHO, which measures
heart size and pumping function and checks for faulty heart valves, and 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
Athletes who have 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, like Reggie Lewis of the Boston Celtics, collapse and die
despite seemingly being in peak physical form, he says.
"Studies have shown that screening all athletes is not cost-effective, so we
wanted to see if there was a way we could refine the screening process,"
Abraham tells WebMD.
Dual Heart Tests Pick Up More Problems
The new study, presented at the annual meeting of the American Heart
Association, involved 134 Maryland high school athletes participating in the
2008 track and 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 and whose patients often have no symptoms.
"We did a very focused exam. First, we took a 10-minute medical history,
then we took weight and blood pressure measurements. Using a stethoscope, we
listened for unusual heartbeats or murmurs. Then, we conducted an
echocardiogram and an EKG," Abraham says.
None of the student athletes was found to have 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, and five were
picked up on both tests.
"If we had only done the ECHO or the EKG, a significant number of
abnormalities would have 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
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,"