Heart research on young athletes yields no easy answers

WASHINGTON — What kind of heart check-up do young athletes need to make the team? A large study of teenage soccer players in England found in-depth screening didn’t detect signs of trouble in some athletes who later died yet allowed others at risk to get treated and back in the game.

At issue is cardiac arrest, when the heart abruptly stops beating. It is rare in young people, especially athletes thought to be at the peak of health.

But sometimes the strenuous exertion triggers an underlying heart problem, and how to find the young athletes most at risk before a collapse is hotly debated. Do they need routine EKGs added to their pre-sports check-ups? The American Heart Association doesn’t recommend it, but European guidelines do.

British researchers tracked how players fared in a costly screening program — and found no easy answers.

As expected, the vast majority of the teen players were healthy. But 1 in 266 was found to have silent heart disorders that put them at risk of sudden cardiac arrest, researchers reported Wednesday in The New England Journal of Medicine.

The good news: More than twothirds of the 42 high-risk players had conditions that were fixed with surgery so they could safely return to play, said Dr. Sanjay Sharma, a cardiology professor at St. George’s University of London, who led the work.

The risk equates to 6.8 deaths per 100,000 athletes, Sharma’s team calculated.

The numbers may be small but “it seems like if it’s potentially preventable, we should probably be doing that,” said University of Washington sports medicine specialist Dr. Kimberly Harmon, who wasn’t involved with the British research.

But extra screening can be costly. The American Heart Association recommends a thorough physical exam and detailed family and personal medical history for every athlete, but not an automatic EKG.

At a cost of $25 to $100, automatic EKGs aren’t practical for millions of high school and college athletes especially since false alarms can require pricier further exams, said Dr. Douglas Zipes of Indiana University, who co-authored the heart association guidelines.