Heart tests could save athletes

Testing athletes’ hearts dramatically lowered the rate of sports-related sudden cardiac deaths in Italy, a study suggests, but experts said it was not clear such an effort would have as big a payoff in the United States.

There are about two dozen sports-related deaths of high school and college students from sudden cardiac arrest in the United States each year. Only a few schools require electrocardiogram, or EKG, screening.

Since 1982, Italy has required all athletes to get EKGs for hidden heart problems before playing competitive sports, and about 2% are disqualified because of heart problems.

Researchers from the University of Padua Medical School analyzed trends in sudden deaths from heart problems before and after the program began. They looked at athletes and nonathletes, ages 12 to 35, in the Veneto region of northeastern Italy between 1979 and 2004.

They found that the rate of sudden deaths among athletes fell by 89% over the 25-year period. The rate among nonathletes did not change.

Dr. Barry Maron, an expert on heart problems in athletes at the Minneapolis Heart Institute Foundation, praised the research, which appears in the Oct. 4 issue of the Journal of the American Medical Assn.

“This is an important paper,” Maron said. “The findings show for the first time that pre-participation screening of young athletes is effective, not only in recognizing otherwise unsuspected heart disease, but also because that recognition actually reduces the risk of sudden cardiac death during sports.”

Maron said it would be difficult for the United States to gear up for a similar program to screen what he estimated would be 10 million people a year.

Each year in the United States, there are 20 to 25 sudden cardiac deaths among high school and college athletes, according to data collected by the National Center for Catastrophic Sport Injury Research.

A few U.S. universities now run screening programs that include EKGs, said Ron Courson, director of sports medicine at the University of Georgia, which has done the tests on would-be athletes for the last 12 years.

During that time, only one athlete has been disqualified because of detected heart problems, although 10 to 12 students have been found to have minor problems. They have been treated and allowed to play, Courson said. The testing costs about $20,000 a year, he said.

“In the U.S., the leading cause of death in athletic systems is cardiac arrests,” he said. “The more data we have on this, the better equipped we are to make a decision.”