Checklist May Help Cut Sudden Death in Athletes

12-step screen can spot underlying heart problems, experts say

FRIDAY, March 16, 2007 (HealthDay News) -- A 12-step screening process may help reduce sudden cardiac deaths in young athletes, according to an updated scientific statement released this week by the American Heart Association.

The rate of sudden cardiac death in American high school-age athletes is still rare -- about one in 200,000, according to one 12-year Minnesota study of 1.4 million young athletes taking part in 27 sports. Many of these deaths occur in football and basketball, which are high intensity sports with high levels of participation.

"Although the frequency of these deaths in young athletes appears to be relatively low, it is more common than previously thought and does represent a substantive public health problem," Dr. Barry J. Maron, chair of the panel that wrote the updated guidelines, said in a prepared statement.

The recommended screening process includes 12 questions about personal and family medical history and a physical examination. Doctors should ask questions about:

  • chest pain/discomfort upon exertion;
  • unexplained fainting or near-fainting;
  • excessive and unexplained fatigue associated with exercise;
  • heart murmur;
  • high blood pressure;
  • one or more relatives who died of heart disease (sudden/unexpected or otherwise) before age 50;
  • close relative under age 50 with disability from heart disease;
  • specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy in which the heart cavity or wall becomes enlarged; "long QT syndrome" which affects the heart's electrical rhythm; Marfan syndrome, in which the walls of the heart's major arteries are weakened; or clinically important arrhythmias or heart rhythms.

The physical examination should note:

  • heart murmur;
  • femoral pulses to exclude narrowing of the aorta;
  • physical appearance of Marfan syndrome;
  • brachial artery blood pressure (taken in a sitting position).

If any of the 12 screening elements yields a "yes" answer, the patient should be referred for further cardiovascular examination, the scientific statement said.

More information

The U.S. National Heart, Lung, and Blood Institute has more about sudden cardiac death.

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