The pros and cons of heart abnormality screenings for athletes

Screening athletes for hidden heart problems seems like a wonderful idea on the surface -- why not try to prevent young athletes from dying via an electrocardiograph test?

But the subject is controversial. While some physicians and researchers advocate mandatory ECG screenings, others insist the screenings are a bad idea, considering the high rate of false positive results, the extremely low death rates, and the fact that nonathletes can die from undetected heart abnormalities as well.

Anyone interested in both sides of the debate can check in with a new report published this week in the British Medical Journal that includes opposing views on the subject.

On the “yes” side are Antonio Pelliccia, scientific director of the Institute of Sports Medicine and Science, Italian National Olympic Committee, and Domenico Corrado, associate professor, department of cardiac, thoracic and vascular sciences at the University of Padua Medical School in Italy. Their argument is largely based on the apparent success of Italy’s mandatory pre-participation screening program for athletes. After screenings were put into practice, sudden deaths fell 89%. They write, “Moreover, no deaths were recorded among athletes disqualified from competition because of hypertrophic cardiomyopathy, supporting the idea that timely identification of affected athletes offers the possibility to improve survival.”

On the “no” side is Roald Bahr, professor of sports medicine at the Norwegian School of Sport Sciences in Oslo, Norway. He argues that not all heart abnormalities may be detected by ECG screening, and that the rate of false positives on screenings could be as high as 40%. He writes, “Although sudden cardiac death is tragic, it is also rare. ... Screening of hundreds of thousands of athletes to save possibly only one life a year, as would be the case in Norway, cannot be justified.”

-- Jeannine Stein / Los Angeles Times