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Pediatric cardiologists not always accurate in interpreting ECG results for young athletes
Date:7/13/2011

with heart defects. The physicians, who had an average of five to 15 years of experience in their field, accurately diagnosed the heart conditions only 67 percent of the time. They correctly permitted sport participation for healthy individuals 74 percent of the time, and correctly restricted sport participation for those with cardiac defects 81 percent of the time.

"As athletes' hearts grow stronger, they undergo some changes that make it very difficult to tell: Is this a well-trained athlete or does this person have some underlying disorder that may predispose them to sudden cardiac death?" Hill said. A fit heart tends to grow somewhat larger and beat more slowly, which can make it look similar on an ECG to a defective heart vulnerable to sudden cardiac death. This similarity could lead to unnecessary exclusion of healthy young people from sport participation.

Conversely, some young athletes who are predisposed to sudden cardiac death may be given a clean bill of health based on a flawed ECG interpretation.

"We need to be careful about giving a false sense of security to families, parents or an entire community if we have an ECG that's normal," Hill said. "It's important to know that it's not a perfect test."

The physicians' accuracy at interpreting ECGs varied depending on what heart defect they were looking at. They were most accurate at picking up long QT syndrome and myocarditis, showing 98 percent and 90 percent accuracy at restricting sport participation for these two conditions. In contrast, they correctly restricted sport participation for patients with hypertrophic cardiomyopathy, Wolff-Parkinson-White syndrome and pulmonary arterial hypertension 80 percent, 64 percent and 38 percent of the time, respectively. (The poor result for pulmonary arterial hypertension may be due to the fact that it is much rarer than the other diagnoses, occurring in 30-50 people per million, whereas most of the other diagnoses are seen at a
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Contact: Erin Digitale
digitale@stanford.edu
650-724-9175
Stanford University Medical Center
Source:Eurekalert

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