Heart tests could save athletes
2008-07-04 09:03
London - Mandatory heart screenings for
all athletes could detect potentially fatal problems and save
lives, Italian researchers said on Friday.
The issue of pre-screening programmes using
electrocardiograms is controversial but the findings published
in the British Medical Journal suggest that a family history and physical exam may miss many undiagnosed heart problems.
"Among people seeking to take part in competitive sports,
exercise electrocardiograms can identify those with cardiac
abnormalities," Francesco Sofi and colleagues at the Institute
of Sports Medicine at the University of Florence wrote.
Last year, Sevilla footballer Antonio Puerta died three days
after collapsing during a Primera Liga match and Cameroon's
Marc-Vivien Foe died during a Confederations Cup match in 2003.
Young athletes
The risk is not just for top athletes either. Figures show
one young athlete dies every three days from an unrecognised
heart problem in the United States alone, the Italian
researchers said.
For their study, Sofi and colleagues analysed data from more
than 30 000 heart screenings during a five year period between
2002 and 2006. Italy is the only country where these tests are
mandatory, Sofi added.
The study found 1 459 showed some form of heart problem
during an exercise electrocardiogram and 348 people had abnormal
results during their resting electrocardiogram.
Of these, 159
had conditions serious enough prevent them from competing.
Yet, only six of these athletes would have been identified
through a family history and physical examination, Sofi said in
a telephone interview.
The results bolster arguments that the tests costing about
€40 should be mandatory in other countries, he added.
Risk of sudden death
Not everyone agrees. The American Heart Association in 2007
reaffirmed their recommendation against universal use of
electrocardiography, citing cost, low prevalence of disease and
a high false positive rate.
The European Society of Cardiology, International Olympic
Committee and other sports league endorse the screenings on
grounds on grounds some studies have found them effective,
Jonathan Drezner of the University of Washington, wrote in an
accompanying editorial.
"Although a detailed personal and family history and
physical examination will detect an important but limited number
of athletes with underlying (heart) disease, adding
electrocardiography to the screening process will detect more
athletes with silent cardiovascular disorders at risk of sudden
death," he wrote.