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Clearing Kids for Sports Participation Sparks Conflicts
Date:9/10/2010

taken] from the athlete as well as the athlete's family," explained Dr. Reginald Washington, a pediatric cardiologist and chief medical officer at Rocky Mountain Hospital for Children in Denver and past chairman of the academy's committee on sports medicine and fitness.

The doctor should ask about any chest pain and dizziness, and whether the athlete has ever passed out or experienced a racing or unusual heartbeat, Washington said. The physician should also ask if the athlete's parents have had early heart disease, before age 55 for a man and 65 for a woman. And the physical exam, he said, should be thorough and include listening to the heart, taking blood pressure and feeling the pulse.

"If all of that is normal and the family history is normal, no further tests need to be done," said Washington, echoing the academy's stand.

But others disagree strongly, calling for universal and extensive testing of all young athletes to avert future tragedy.

Heart experts from Johns Hopkins Medicine in Baltimore contend that both an EKG and an echocardiogram -- which is an ultrasound that measures heart size, pumping function and checks for faulty heart valves -- are crucial to detect early signs of heart defects in young athletes because neither test alone will catch all potential problems.

In testing 134 high school athletes competing in the Maryland state track and field championships in 2008, for instance, no life-threatening heart defects were found but blood pressure abnormalities that required further testing and monitoring were detected in 36 athletes, some by EKG and some by echocardiogram, the Hopkins doctors reported at an American Heart Association session in late 2009.

Testing in 2009, according to a Hopkins report, found a serious heart valve disease in one track-and-field athlete and another with an undiagnosed heart condition that could require a transplant in the future. Neither athlete had reported any symptoms.

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