Back-to-School Health Checklist: The Importance of Heart Exams for Young Athletes

Doctor examining child with motherGoing back to school requires a good deal of preparation, from buying a new backpack and school supplies to learning class schedules and locker combinations. However, one area of preparation that is sometimes overlooked is the back-to-school physical, which is important for young athletes. If your child plays school sports, especially sports that require the heart to work hard — such as basketball, football, soccer, running, and swimming — a physical exam focusing on heart health should be a top priority. Unfortunately, it is often treated as a formality or a hoop to jump through. The truth is, it just may save your child’s life if they have an undiagnosed heart problem.

“Every child should go through a detailed pre-participation physical if they plan to play a school sport,” says David Shipon, M.D., Preventive/Sports Cardiologist and Director of Cardiac Rehab at Jefferson Health. “Many kids do not get the appropriate screenings before participating, which are essential for identifying the warning signs of sudden cardiac arrest and other heart-related problems.”

Sudden Cardiac Arrest is Rare but Dangerous
In general, children are strong and resilient when it comes to physical activity and sports. However, when a heart problem occurs, it usually happens while they are playing a sport — sudden cardiac arrest is the leading cause of death in young athletes.

Sudden cardiac arrest is when the heart suddenly and unexpectedly stops beating. There are warning signs, but sometimes, there are not.  When someone experiences sudden cardiac arrest, the heart stops pumping blood and vital organs, including the brain, do not receive the oxygen and nutrients they need. Death can occur within minutes if the condition is not treated.

“During a screening, the doctor will consider your personal and family history. There are so many clues in our histories. He or she will also conduct tests to identify common problems that can lead to sudden cardiac arrest,” says Dr. Shipon. “One of these is called hypertrophic cardiomyopathy, a thickening of the walls of the heart muscle that can cause irregular heart beats and potentially death.”

Safety Starts with a Simple Physical and 14-Point Checklist
As part of the physical your child receives before participating in sport, your doctor should also screen for congenital and genetic heart disease using the American Heart Association’s 14-Point Cardiovascular Screening Checklist. The checklist is designed to identify potential red flags for heart problems in the child’s personal history, family history, or during the physical exam.

“In addition to this checklist your doctor will administer, parents and coaches be on the lookout for other heart-related signs and symptoms they see in young athletes,” says Dr. Shipon. “This includes exertional chest pain, syncope (fainting) or seizures during or immediately after exercise, shortness of breath, a racing heart, and a family history of sudden cardiac arrest under the age of 50.”

When an Electrocardiogram May Help
“If one of the points on the checklist is positive, it means that the athlete is at higher risk for a potential heart problem. This warrants further testing with an electrocardiogram (ECG) and possibly other cardiac test,” says Dr. Shipon. “Research shows that the AHA checklist, when done with an ECG exam using the latest criteria, is more effective at identifying problems with a very low percentage of false positives.”

An EKG measures and records the electrical impulses that cause the heart muscle to contract and pump blood throughout the body. If the young athlete’s symptoms or history suggest that they may have a heart problem, the ECG can help verify it.

“The evolution of sports cardiology has expanded our knowledge of the athlete’s heart,” says Dr. Shipon. “This knowledge along with the right tests and screenings helps us reduce the risks for anyone who wants to participate in school sports.”

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