AHA/ACC: Routine ECGs Not Advised for Young Athletes

Detailed history, examination can reveal teens' risk for sudden death, experts say

TUESDAY, Sept. 16, 2014 (HealthDay News) -- U.S. heart experts recommend doctors use a 14-point checklist rather than an electrocardiogram (ECG) when evaluating young people for underlying heart disease that could result in sudden cardiac arrest.

The American Heart Association and the American College of Cardiology said in a joint statement that a more detailed personal and family medical history along with a physical examination can help identify young people with genetic or congenital (existing from birth) risks for sudden cardiac death. The statement, published Sept. 15 in Circulation and the Journal of the American College of Cardiology, also recommended wider distribution of automatic external defibrillators in public places, such as sports arenas and schools.

According to the recommendations, the questions doctors should ask to evaluate heart risks include whether or not a patient has experienced unexplained fainting, chest pain, or unusual shortness of breath or fatigue during exercise. Young people should also be questioned about their family history, including whether or not any close relatives died at a young age from heart disease or a heart condition involving the heart muscle or heart rhythm. Also, have they ever been restricted from participation in sports or had heart tests ordered by their doctor?

If any of these factors are positive, additional testing may be needed to identify heart defects. Although an ECG can help detect congenital heart disease that can lead to sudden cardiac death, this test should not be used unless a doctor has determined a young person is at increased risk for a heart abnormality, the experts advised. Pediatric ECGs can be particularly difficult to interpret since the results change with growth and development, the experts cautioned. Also, ECG screening for congenital heart defects would be costly, they said. To screen young athletes alone would initially cost at least $2 billion each year.

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AHA/ACC Joint Statement

Physician's Briefing