Re: Should athletes be screened for heart problems? - New Scientist - New Scientist

[Guest guest]

I'm not a doctor - but I think they might be wise do to a slightly more

aggressive testing at least 1 time with athletes - say the treadmill EKG or

ultrasound. (I say this based on the experience of my dad and uncle, who had

NORMAL EKGs....but had definite " widowmakers " . One had the 6 bypass and

survived, the other was missed when screened AFTER the brother had his

surgery....and dropped dead.). Those at risk for sudden death are a very small

minority vs the general population of athletes overall. Cost if paid by the

prospective athlete might also prevent some good candidates from playing (in

some countries the expense would be considerable?).

The subject player had been screened 4x already with no signs of problems? - if

the screening were to be effective, he should have shown symptoms or some

positive response to the tests? Were the rest of his teammates also screened

this many times?

Another good question is the overall tendency of someone to have a heart problem

of this type in the overall population - would we aggressively screen everyone

based on the potential of a small group to have the serious heart problem

potential? clearly this isn't a likely thing for entire countries and exposes

people to more side effects from the screening and possible false positives.

There is also the question of how serious a problem has to be to prevent the

athlete from competition - heart murmurs and other items come into play here?

The questions also are here with the individual case - did he have a family

history or other markers that prompted them to screen him not once but 4x?

There are individual choices in supplementation or recreation (to put it mildly)

that might bring on an unfortunate cardiac event on a soccer pitch....cocaine

and other potentials being out there which may enhance or bring on the cardiac

event. Obviously I am not saying this individual did such a thing, no evidence

of that - but there are also the energy drinks and other possible triggers out

there that a good many folks take in without consideration. An athlete might be

screened and cleared under a normal or ideal condition of not having a substance

in their bloodstream but compete under an altered circumstance - e.g. the hockey

players who take up to 10 pseudoephedrine tablets before the game .....in which

case, the circumstances may unfortunately shift toward an adverse cardiac event.

Where does the caution end? The extension of 'screening " might take us to a

pretty insane place if you consider " screening " to include BMI analysis - say we

took NFL player Tim Tebow and screened him for " cardiac risk " based on his BMI

of 30 (obese) - and required him to " lose weight to get within the guidelines "

as part of " reducing his cardiac risk " . (the joke here is of course that Mr.

Tebow is an extremely lean athlete and the BMI is way off base as usual in

handling of muscular athletes...sigh.). Do we prohibit athletes with controlled

diseases that attack the circulatory system from playing at all? say controlled

diabetics? (that would include another NFL qb - Jay Cutler for one?) If we take

linemen to task, how many would we have left? It is also said NFL players

experience shortened lifespans - should we start to prevent people from playing

the sport because of the danger to their overall lifespans??

Is there another question here - athletes coming from countries with less

developed health care systems might well have been at risk from childhood, but

not had the screening to catch such a tendency? Do we take the only profession

such a person may have from them on the chance they may or may not have the

cardiac event a test suggests may lie in wait?

Good questions all - and every time an athlete collapses, we ask the same

question about " why wasn't this caught " . What I think is that the event could

well have happened walking down the street or running for a bus in their normal

lives, had they not been athletes. It is the public collapse that may be

remarkable, vs a less public problem that may have happened no matter what life

the person in question selected. Perhaps being an athlete delayed the inevitable

in some cases..

The Phantom

aka Schaefer, CMT/RMT, competing powerlifter

Denver, Colorado, USA

Should athletes be screened for heart problems? - New

Scientist - New Scientist

http://www.newscientist.com/mobile/article/dn21615-should-athletes-be-screened-f\

or-heart-problems.html

Driscoll

Sydney Australia

[Guest guest]

This is a tough one. I'm an exercise physiologist in a pediatric cardiology

practice. I run the cardiopulmonary lab and write exercise prescriptions. We see

quite a few children who have had an ECG that the computer has interpreted as

" possible long QT " or " borderline long QT " .

We'll exercise them to see what happens to the QT measurement in exercise. Very

few have any problems. Hypertrophic cardiomyopathy is a different story.

Without question we would save lives testing more athletes. But if we used that

same money for bicycle helmets or AED's would we save more lives? It becomes a

cost-benefit analysis. That said I have had my kids tested since they are

involved in competitive athletics.

http://www.jpeds.com/content/JPEDSHill

http://circ.ahajournals.org/content/115/12/1643.full.pdf

http://www.eurekalert.org/pub_releases/2007-03/aha-1sm031307.php

[Guest guest]

This question comes up every time a prominent athlete dies on the court due to

cardiac arrest. Inviariably the argument against testing often revolves around

the cost of such a program.  How many athletes need to die before the cost of

screening is out weighed by the cost of dying athletes?  

Italy has had in place a system of testing athletes for many years and has seen

a dramatic drop in athletes dying from hypertrophic cardiomyopathy.  This

condition is not related to blocked arteries.  As pointed out by cyclingcoach

an ekg, which is relatively inexpensive is a starter and for those with

questionable findings an Echocardiogram, which is also relatively inexpensive

can be done as a follow up. 

Below is information on HCM.  There are scenting questionairs which can be

helpful in narrowing down to those individuals are high risk and would require

more expensive testing.

Ralph Giarnella MD

Southington Ct. USA 

https://www.4hcm.org/hcm/diagnosis/40255.html

Athletic Preparticipation Screening Guidelines

By  Salberg 02/26/2009 10:39:00

Font size:  

The American Heart Association has published guidelines for pre participation

sports physicials.  The HCMA encourages each State to use these guidelines when

updating there requirements for participation in high schools and college level

programs. In addition the HCMA believes the same questions should be asked of

those children participating in recreational level athletics and " club " teams.

 

Hypertrophic cardiomyopathy is a condition that is generally not compatable with

competitive athletics and therefore those with HCM should not participate in

most athletic programs.  HCM is the leading cause of sudden cardiac arrest in

young athletes.    

________________________________

From: cyclingcoach1 <cyclingcoach@...>

Supertraining

Sent: Thursday, March 22, 2012 1:04 PM

Subject: Re: Should athletes be screened for heart problems? -

New Scientist - New Scientist

 

This is a tough one. I'm an exercise physiologist in a pediatric cardiology

practice. I run the cardiopulmonary lab and write exercise prescriptions. We see

quite a few children who have had an ECG that the computer has interpreted as

" possible long QT " or " borderline long QT " .

We'll exercise them to see what happens to the QT measurement in exercise. Very

few have any problems. Hypertrophic cardiomyopathy is a different story.

Without question we would save lives testing more athletes. But if we used that

same money for bicycle helmets or AED's would we save more lives? It becomes a

cost-benefit analysis. That said I have had my kids tested since they are

involved in competitive athletics.

http://www.jpeds.com/content/JPEDSHill

http://circ.ahajournals.org/content/115/12/1643.full.pdf

http://www.eurekalert.org/pub_releases/2007-03/aha-1sm031307.php

[Guest guest]

I am not a doctor, however I think that athletes should be screened for heart

problems. Athletes really exert themselves and it can really affect the heart.

Screenings can prevent a lot of problems, both in the short and long term, and I

think they should be required.

Philip Hoffman

Norton, Ohio

>

>

http://www.newscientist.com/mobile/article/dn21615-should-athletes-be-screened-f\

or-heart-problems.html

>

> Driscoll

> Sydney Australia

>