Why and When to Schedule a Heart Screening for Your Student-Athlete

For student-athletes, back to school means back to sports – and that requires a sports physical. As stories of cardiac arrest in young athletes become more widespread, many parents choose to add a heart screening to their child’s physical, to detect any hidden heart conditions.

Sudden cardiac death in young athletes is definitely rare, affecting only about one in 200,000 athletes per year. Most are caused by rhythm disturbances, structural abnormalities and hidden heart conditions that may not show symptoms. Unfortunately, a routine sports physical often does not identify the athletes at greatest risk. That’s why OhioHealth has developed a preparticipation heart screening – a simple, 15-minute, noninvasive test developed by our team of sports cardiology physicians.

Heart screenings are available for students and young adults age 14 and older. Our cardiologists recommend them for any active teen, whether they play organized sports or not.

We asked OhioHealth cardiologist Kanny Grewal, MD, FACC, FASE, FASNC, about the benefits, process and importance of heart screenings for student-athletes. Here’s what he had to say:

How does the heart screening process work?

“We screen for a wide variety of conditions that can cause sudden death in athletes. The screening picks up about two-thirds of the detectable causes, but it is important to emphasize that not all conditions can be detected on a single screening,” says Dr. Grewal.

Screenings typically take about 15 minutes, are noninvasive and include:

• A questionnaire.
• An electrocardiogram (EKG), which measures the electrical activity of the heart.
• An echocardiogram, which is like an ultrasound or sonogram of the heart.

Screenings detect:

• Heart rhythm disorders.
• Structural conditions.
• Enlargement of the heart.
• Leaky heart valves.
• Other heart valve disorders.

What are the benefits of heart screenings?

Many parents choose to add heart screenings to a child’s sports physical simply for reassurance; others may have a family history of heart problems. These screenings aren’t meant for kids who already have a documented cardiovascular condition.

Teens who have experienced the following symptoms should undergo a complete medical evaluation by their team physician, trainer or family doctor, rather than a screening:

• Elevated blood pressure.
• Unexplained fainting, or a temporary loss of consciousness due to a drop in blood pressure.
• Severe fatigue during exercise.
• Exertional chest pain.
• Prior instance of a heart murmur.

How much do heart screenings cost? Are they covered by insurance?

Supplemental heart screenings are not covered by insurance, but OhioHealth offers them for $95.

How long does it take to receive the results?

Our heart and vascular sports cardiologists review your results and mail a written report within two business days. We can also send the results to your child’s primary care physician, if one is listed at the time of registration.

Are heart conditions common in teens? How often should student-athletes have screenings?

“No, and that’s the challenge,” says Dr. Grewal. “The instances of positive screenings are very low, which is why screenings aren’t mandatory – just optional.”

Heart screenings are really only needed once, not every year like a regular physical. If a screening is performed before age 17, another screening may be needed once an individual has reached college age.

Is there a possibility for false positives?

“Yes, false positives are always a possibility, although they’re more common with an EKG, which is why we use both an EKG and an echocardiogram to try to reduce instances of false positives as much as possible,” says Dr. Grewal.

Are there certain sports where it may be more important for athletes to have a heart screening?

Not necessarily. The highest risk sports are the ones that are the most cardio-intensive, like soccer, basketball, cross country and swimming. However, any sport with physical demand could present a risk.

If a heart screening detects a problem, does that mean athletes can’t participate in sports anymore?

“Not necessarily,” says Dr. Grewal. “It just means they will have to consult their primary care doctor, pediatrician or a cardiologist to determine the next steps. That usually involves additional testing. However, your athlete may need to avoid his or her sport until the next steps are taken. Usually, only a small percentage are prevented from further participation.”

At OhioHealth, we believe there’s nothing more important than your family’s health. Schedule a preparticipation heart screening at OhioHealth for your student-athlete today. For more information about heart screenings, visit the OhioHealth Sports Medicine website.