Competitive Athletes Need Heart Screens

(July 6, 2008) - This year, during the men's Olympic marathon trials, one of the top runners collapsed and died. The runner had an enlarged heart (Read about "Enlarged Heart") but had been cleared by doctors to run. He is one of the few that knew he had a potential heart problem. Most athletes with heart problems don't know. According to a study, one young competitive athlete dies every three days from an unrecognized cardiovascular disorder.

Athletes who take part in competitive sport should be screened for potentially fatal heart problems (Read about "The Heart & Cardiovascular System") before they compete, according to a study published on BMJ.com. The findings show that a pre-participation screening program, which involves checking the activity of the heart during exercise, would detect more athletes at risk of sudden cardiac death and save lives, say the authors.

In America and Europe authorities have recommended a pre-participation evaluation which includes taking a detailed patient and family history as well as a physical examination. However, in Italy for the past 25 years, athletes wishing to enter competitive sport have also had to have two ECGs (a test to measure the electrical activity of the heart), one at rest and one while exercising. (Read about "Cardiovascular Tests")

Researchers analyzed data from 30 065 athletes who underwent a complete pre-participation cardiovascular evaluation during a five year period.

During the resting ECG they found that 1.2 percent (348) of participants had distinctly abnormal test results. However, the results from the ECGs taken during exercise found that 4.9 percent of participants (1459) had some form of heart abnormality. So a significant number of heart problems were only evident during exercise.

The age of people with problems found only during the exercise ECG, was also significantly higher (30.9 years old compared to 24.9 years old) than those who had normal test results.

Importantly, of the 159 people disqualified from sport for identified heart problems, only six would have been picked up through history and physical examination alone, meaning nineteen in twenty would have been missed. Eight in ten (79.2 percent) would have been missed if they had only had a resting ECG.