Heart problems in young healthy people are rare.
Nevertheless, an estimated 12 young people die every week in the UK from sudden cardiac death (SCD).
Many of these events are related to athletics or sporting activities.
Young athletes have a higher probability of SCD than non-athletes.
In a series of 1101 athletes under the age of 35 who suffered SCD, 50% were under 18 years old. 90% of sudden deaths in young athletes are due to pre-existing abnormalities of the heart. A simple screening protocol may identify such abnormalities.
Currently in the UK there is no systematic screening programme for heart conditions in most young people participating in sport although there are screening programmes for elite or professional sportsmen and women.
Other countries, such as Italy have screened all teenagers participating in sport for heart problems for many years and have seen a drop in the number of cases of SCD.
A long term study in Italy during the period 1979 - 2004 saw the annual incidence of SCD decrease by 89% in young athletes who had been screened.
The “Lausanne recommendations” (2004) for pre-participation screening in sports were developed by a panel of experts in Cardiology and Sports Medicine and has been endorsed by the International Olympic Committee.
They were developed as a simple screening protocol for identifying young athletes who may have an increased risk of suffering a heart condition associated with SCD.
Such a screening protocol may identify up to 80% of individuals who may be at risk of this rare but important problem.
Cardiascreen has taken the “Lausanne recommendations” and used them to develop a fast and efficient screening programme for young athletes participating in sports at school and university level.
The programme involves:
- A consent form explaining the procedure for the athlete or their parent(s) or guardian to sign as appropriate.
A short questionnaire to help to identify individuals with an increased risk.
A clinical examination of the cardiovascular system including listening for heart murmurs.
An electrocardiogram (ECG) which is a simple test to look at the electrical activity of the heart. It involves placing 10 sticky electrical leads on the arms, legs and chest which are able to monitor the heart. It is not uncomfortable or painful.
A private discussion with a doctor as to what the results mean, followed by a letter outlining the findings.
In 96 to 98% of participants, no abnormality will be found on initial screening, and the athlete can be reassured that they are in a very low risk category and can participate in sporting activities normally. In 2 to 4 % of participants may be identified as having some factor which causes concern in either the history, examination or ECG.
In this situation there will be the opportunity to have a private, confidential discussion with the doctor about the meaning of the result and a plan for further investigation or referral on for specialist tests. Typically the athlete will be offered an echocardiogram (echo) which is an ultrasound of the heart to identify any structural abnormalities. Other tests such as a heart monitor or exercise test or MRI scan are sometimes recommended to assess the functioning of the heart. After all the tests are completed a recommendation about participating in sport will be discussed.
In a recent series 143 normal participants were screened for every one serious cardiac condition found so the vast majority were able to continue with their sporting interests.