Good Question: Should Young Athletes’ Hearts Be Screened?
CBS Minnesota (con't)
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MINNEAPOLIS (WCCO) — When 16-year-old Wes Leonard suddenly died right after hitting the winning shot in his Michigan high school basketball game, doctors say he had an enlarged heart. But how many of us are walking around with enlarged hearts, and should high school athletes be getting tested for the problem?
“It really strikes fear in everyone’s heart. We look at these young competitive athletes as the epitome of health,” said Dr. Peter Eckman, a cardiologist with University of Minnesota Physicians.
The University of Minnesota Medical Center Fairview treated Zach Gabbard, a Perham, Minn. basketball player whose heart stopped in the middle of a game.
“There are some tests that are highly suggestive,” said Eckman.
An electrocardiogram (ECG) would give clues. In Italy, high school students have to get an ECG before they play any competitive sports.
“There’s a significant debate in the scientific community on this,” he explained.
According to the American Heart Association, if you took 10 million high school athletes and gave them all a $75 ECG, it would cost $750 million.
“And that ignores the fact that 10 percent would need additional testing. The total cost is about $2 billion per year,” said Eckman.
The AHA estimates that it would cost $3.4 million to prevent each theoretical death. In a report on cardiovascular screening, the AHA writes: “The fundamental issue … concerns the practicality and feasibility of establishing a continuous annual national program for many years at a cost of approximately $2 billion per year.”
In addition, according to Eckman, athletes can have enlarged hearts for many reasons. Sometimes it’s a genetic defect, sometimes it’s because the heart is a muscle and they’re athletes.
But if the hearts walls are thicker than normal, that can be a problem called Hypertrophic cardiomyopathy. According to the AHA, HCM is the most common reason U.S. athletes die suddenly.
“People with that condition have an increased risk of electrical problems in their heart that lead to an electrical storm,” he said, adding the abnormal thickness of the heart walls “blocks the cavity of the heart which makes it difficult for blood to get out.”
But an ECG wouldn’t tell you about what caused Zach Gabbard’s heart trouble. According to Gabbard’s Caringbridge page, he had a viral infection that led to the heart stopping.
“These tests can also turn up a lot of false positives and lead to a lot of worry and unnecessary testing,” said Eckman.
One study of 1.4 million Minnesota student athletes over 12 years found 1,435 died of heart problems. That’s an incidence rate of about 1 death per 200,000 young athletes.
“We hear about [these cases] because it’s so striking, the odds of having it are so low,” said Eckman.