Parents Should Seek a Cardiac Screening for their Child Athlete

By: Barbara Sears, ARNP

As a community, we value our student athletes and their performances, both athletically and academically. They bring great pride to their school by winning competitions and excelling in their respective sport. However, because of the large physical demands that come with being an athlete, parents should take precautions before their child engages in any athletic activity, including dance, football, basketball, softball, track, and recreational sports.

We often see in the news the tragic stories of young, strong, athletic kids who collapse because of sudden cardiac arrest while in the middle of a sporting event. This tragedy can happen to any child regardless of their age or weight. In fact, it can even happen to adults.

According to the American Heart Association, approximately 210,000 people die unexpectedly each year in the United States due to sudden cardiac arrest. In addition, sudden cardiac arrest occurs twice as frequently in African American athletes.

Unfortunately, because many do not show symptoms prior to, it is difficult to prevent sudden cardiac arrest. These cases are often the result of undiagnosed cardiac diseases, such as:

• Hypertrophic cardiomyopathy (HCM) – The most common cause of sudden cardiac death; a genetic disorder in which the walls of the heart muscles thicken and can lead to fast or irregular heartbeats called arrhythmias.
• Anomalous coronary artery (ACA) – The second most common cause of sudden death in young athletes. ACA is a congenital abnormality or malformation in the arteries that feed the heart muscle.
• Myocarditis– An infection/inflammation of the heart muscle that weakens the heart. It is usually caused by a viral infection; a severe case can lead to heart failure, and abnormal heartbeat, and/or sudden death.
• Electrophysiological abnormalities –   Abnormal heart rhythms (arrhythmias) that can lead to the need of medicine, a pacemaker, an implantable cardioverter defibrillator (ICD), cardiac ablation, and/or surgery.

Unfortunately, sometimes children do not show symptoms until they are in cardiac arrest, or until it is too late. But parents/guardians should watch for the following warning signs:

• Dizziness or fainting, particularly after exercise or being in the sun for extended periods
• Heart murmur heard during a physical exam
• Fatigue more than other siblings or peers
• Shortness of breath, wheezing, chest pain, or abnormal heart rhythms

Many of these conditions can be treated, and deaths can be prevented. Student athletes are required to take a physical exam before the start of each school year, which makes it more accessible to treat undiagnosed heart conditions. However, cardiac screenings are not often part of routine physical exams. It is important that student athletes tell their doctors about symptoms they may have experienced when participating in any kind of physical activity. During these exams, abnormalities, such as a heart murmur, can be detected and the child may be referred to a cardiologist. An electrocardiogram (EKG) can often detect abnormal heart rhythms or electrical activity.

Also, parents, teachers, and coaches should be trained in cardiopulmonary resuscitation (CPR). In the event of sudden cardiac arrest, a life-saving intervention can begin before the arrival of emergency medical personnel. Sudden cardiac arrest can cause a young athlete to collapse with no warning.

If you believe your child may have a cardiac problem, contact the Children’s Heart Center (CHC) at Holtz Children’s Hospital for an evaluation by dialing 305-585-KIDS. The Children’s Heart Center is an internationally respected center for the comprehensive care of children and adults with congenital and acquired heart disease.

By proactively tackling the risk of sudden cardiac death, we can lower this public health risk so that talented young athletes can fulfill their dreams and continue to bring pride to their communities.

Barbara Sears is a nurse practitioner (ARNP), Pediatric Intensive Care, at the Children’s Heart Center at Holtz Children’s Hospital.