Summer marks a time when many parents are making appointments for their student athletes to get their sports physicals. Required by most school systems to participate in school sports, the sports physical screens for many conditions, including heart disease.
Sports physicals can be completed by any of several different healthcare providers, including pediatricians, family doctors, nurse practitioners or walk-in clinics. The American Academy of Pediatrics publishes the Preparticipation Physical Evaluation forms that are most often used for schools.
These forms contain questions which identify “red flag” items that may indicate underlying heart disease in student athletes, said Sibley pediatric cardiologist Brian Cardis, MD.
“For instance, if there is a history of dizziness, fainting, chest pains or extreme shortness of breath with exercise that can’t be explained by other conditions or a family history of sudden cardiac arrest (SCA), drowning, or Sudden Infant Death Syndrome (SIDS), the pediatrician or provider may refer them to us for further evaluation,” Dr. Cardis said.
Sudden cardiac death in student athletes is fortunately very rare, with only about one occurrence in Georgia each year. Screening hundreds of thousands of children each year to find the one who could have a poor outcome is a bit like trying to find a needle in a haystack. However, preparticipation screening is also beneficial because in addition to helping prevent SCA in the athlete, there are several other significant cardiac conditions that can be identified using this process.
However, no matter how many questions are asked, it’s not a guarantee that you will catch everyone. But sports physicals will identify the majority of conditions that can possibly cause SCA,” Dr. Cardis said.
Dr. Cardis said that having an emergency action plan in place at schools and sports venues is an important additional method of preventing sudden death in athletes. Children’s Healthcare of Atlanta started Project S.A.V.E., which stands for Sudden cardiac arrest Awareness Vision for prevention Education, in 2004 with the mission of promoting and improving prevention of SCA in children, adolescents and others in Georgia communities. Project S.A.V.E. brings automated external defibrillator (AED) and CPR training directly to Georgia schools, athletic leagues and community centers. When sudden cardiac arrest occurs outside of a hospital, a person only has about a 10 percent chance of survival. However, if the cardiac arrest occurs in a Georgia school that has been prepared for such an event through Project S.A.V.E., the survival rate jumps to 80 percent.
Dr. Cardis also warns that echocardiogram screening currently being offered at many area schools can give parents a false sense of security.
“This type of screening only identifies one cause of SCA and can’t even rule that out completely,” Dr. Cardis said. “It doesn’t really paint the whole picture, and parents are encouraged to get a formal evaluation using the Preparticipation Physical Evaluation forms, a detailed family history and a complete physical exam.”
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