Guidelines for sports physicals not widely followed, study finds

The deaths of high school athletes who collapse suddenly during practice or a game have led to new guidelines for screening prep athletes for hidden heart problems before the start of a season.

However, a study released Sunday shows that the vast majority of doctors charged with such screenings don’t follow the recommendations. Researchers at Seattle Children’s Hospital and the University of Washington surveyed 1,113 pediatricians and family doctors and 317 high school athletic directors and found that fewer than half of the doctors and only 6% of the athletic directors were even aware of the guidelines.

The study found only about 6% of the doctors fully follow the national guidelines for assessing sudden cardiac death risk.

About one of every 30,000 to 50,000 high school athletes dies each year from cardiac arrest. Screening guidelines have existed since 1996. In 2007, the American Heart Assn. reaffirmed the guidelines, which consist of questions that are posed to the athlete as well as four physical exam elements.

Key aspects of the screening process include asking whether the athlete has ever had chest pain during exercise or if he or she has a family history of heart disease or early death.

“We need new directions to educate providers and improve policy requirements so patients can actually benefit from these national recommendations,” said the lead author of the study, Dr. Nicolas Madsen, a pediatric cardiology fellow at Seattle Children’s Hospital.

The study was presented Sunday at the American Heart Assn. Scientific Sessions conference in Orlando, Fla.

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