Oakwood urges additional questions during pre-athletic exams

Death from dilated cardiomyopathy—or an enlarged heart—is rare and difficult to predict, but parents and young athletes alike can help protect themselves by knowing their family health history and asking a few basic questions of their health care providers, said representatives of Oakwood Healthcare, Inc. (OHI).

Cardiomyopathy is a major cause of death in young athletes who seem completely healthy but die during heavy exercise,” said Jeff Kline, director of Sports Medicine for OHI. “The condition is usually passed down through families, or inherited. Often the only precursor or symptom is sudden cardiac death.”

The issue received national attention recently, when 16-year-old Wes Leonard collapsed and later died after scoring the game winning basket in a high school basketball game. The tragedy has left parents, school officials and health care providers asking what, if anything could have been done to prevent it.

The necessity for diagnostic tests such as EKGs and Echocardiograms as a routine component of the pre-participation physical exam for student athletes has been debated for years. There is a low rate of actual positive tests from echocardiograms, but often a high number of false positives and the considerably high cost of completing a mandatory diagnostic test and subsequent follow-up testing of false-positive results has been estimated at more than $126 million, nationwide.

Still, the American Academy of Family Physicians (AAFP) has developed a list of cardiovascular screening questions that should be included in the pre-participation physical exam, according to Kline. They are:

• Have you ever passed out or nearly passed out during or after exercise?
• Have you ever had discomfort, pain, or pressure in your chest during exercise?
• Does your heart race or skip beats during exercise?
• Has a doctor ever told you that you have high blood pressure, high cholesterol, a heart murmur, or a heart infection?
• Has a doctor ever ordered a test for your heart (e.g., electrocardiography, echocardiography)?
• Has anyone in your family died for no apparent reason?
• Does anyone in your family have a heart problem?
• Has anyone in your family died of heart problems or of sudden death before 50 years of age?
• Does anyone in your family have Marfan syndrome?

Oakwood Sports Medicine often conducts pre-participation physical exams for the student-athletes and Kline said the use of the adapted AAFP cardiovascular screening questions is part of the process. He urged athletic programs at schools should adopt them, too.

“You can never fully eliminate the risk of participating in team sports, but it is well worth your while to ask these questions,” he said.

For additional sports medicine related news, visit the Oakwood Sports Medicine blog.