Young Athlete ECG Screens Inaccurate

ECGs during sports physicals often fail to identify sudden cardiac death risk

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) A number of teen athletes have suffered fatal heart problems during sports practice, leaving doctors scrambling to find a way to prevent such deaths. ECG screenings had been suggested, but they may not be accurate.

Some physicians have requested mandatory electrocardiogram screenings during sports physicals to catch undetected heart problems, but the effectiveness of such screens is questionable. The research will be published in The Journal of Pediatrics.

"Seek a physical from a physician trained in identifying heart problems in athletes."

Dr. Allison Hill and a team from Stanford University School of Medicine and Lucile Packard Children's Hospital and Pediatric Cardiology Associates have found that such ECG screenings are often inaccurate.

As part of her study Dr. Hill asked 53 pediatric cardiologists to review 18 ECGs. Of those images, eight were from children with healthy hearts and 10 were from children with heart conditions that made them vulnerable to sudden cardiac death. The overall accuracy of the doctors was 67 percent.

The cardiologists accurately restricted sports participation for 81 percent of the children with heart conditions and correctly allowed participation for 74 percent of the children with healthy hearts.

Dr. Hill said that one problem is that as athletes' hearts strengthen, they tend to grow larger and beat more slowly. Though this is normal for a well-trained athlete, on ECG scans it can appear similar to defects that put individuals at a higher risk for sudden cardiac death.

She said healthy children could be excluded from sports based on ECG reviews and those with heart conditions could get clearance they should not have received to play sports.

The researchers believe that ECGs may not be an appropriate screening tool to because they can be inaccurate and are difficult to interpret, stipulating that if the screening is used it should be interpreted by a properly trained doctors.

The sheer number of young athletes -- which number more than 10.7 million -- also makes the process cumbersome.

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Review Date: 
July 18, 2011
Last Updated:
July 23, 2011