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Subscribe to RSSTeen athletes at risk for sudden cardiac death may be falling through the cracks because doctors are skipping parts of screening exams, a new study shows.
In pre-season physicals for high school sports, fewer than 6 percent of doctors followed the potentially life-saving screening guidelines suggested by the American Heart Association, according to a report presented at the Heart Association’s annual meeting.
While doctors typically listen to young athletes’ hearts and record blood pressures, they often fail to ask important questions designed to ferret out heart disease risk. For example, 67 percent of surveyed doctors said they didn’t always ask teens whether any family members suffered from heart problems.
Even more alarming – barely half of the physicians were even aware that the AHA guidelines existed.
More than 7 million teens play high school sports, according to Dr. Nicolas Madsen, a cardiology fellow at Seattle Children’s Hospital of the University of Washington. Studies show that sudden death occurs at a rate of one in 30,000 to 40,000. That translates into 175 to 233 deaths each year among high school athletes.
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Recently, there’s been a push to add more tests, such as electrocardiograms, to the standard student-athlete physical, said Madsen, the study’s lead author. But we can’t know whether those additional tests are necessary until all physicians are following current guidelines to the letter, Madsen added.
For the new study Madsen and his colleagues sent out surveys to every family practice doctor and every pediatrician in Washington State. The response was high with 72 percent of pediatricians and 56 percent of family practitioners returning surveys.
Doctors did most poorly when it came to asking about the heart health of teens and their families.
- 28 percent didn’t always ask if a teen had chest pain during exercise
- 22 percent didn’t always ask if the teen ever experienced unexplained fainting
- 26 percent didn’t always ask about a family history of early deaths
- 67 percent didn’t always ask about a family history of heart disease.
While it’s heartening to see that most doctors did remember to ask about sudden deaths in a teen’s family, it’s distressing to see that more than two thirds of doctors weren’t always asking about a family history of heart disease in their exams, Madsen said.
That means that doctors could be missing families in which there were recognized heart problems, but no one had died.
For Dr. Gaurav Arora the biggest surprise in the new study was the number of physicians who said they didn’t always ask about chest pain or fainting.
“Those are red flags in young athletes,” said Arora, associate director of electrophysiology at the Children’s Hospital of Pittsburgh and an assistant professor of pediatrics at the University of Pittsburgh.
One explanation for the new findings is that there is no single form being used by doctors doing pre-season physicals for student athletes, Arora said. Things would be a lot simpler if everyone used the same screening criteria.
Beyond that, Arora said, “we need better education across the board for all providers doing screening.”
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I remember sitting in health class and the teacher telling us "Young people don't get heart conditions." Unfortunately, this myth seems to be a common belief among parents as well as medical staff. Anyone ( regardless of age) who puts their body through the stress and strains created by sports should have their hearts checked out.
Doctors need to slow down a little and do their job.
its not that. This article brings up an important fact that not many drs take this history. What it leaves out though is that taking these histories has never been shown to decrease athlete deaths. In fact, most of the problems that cause sudden death on the field don't have any precursor symptoms
QUIT BLAMING THE DOCTORS FOR EVERYTHING!! If we all took better care of ourselves and our loved ones, their jobs would be a hell of a lot easier and CHEAPER, TOO!! The public too often ties their hands and then makes a guessing game out of what is wrong with them, like good old 20 questions!
There is one other question that should be asked of these young athletes and their families. They should be asked if they were premature or there were any problems at birth. Since there are more and more premies and children born with problems that are fixed when a few days or months old, this needs to be looked at too. Even though they are "cured", things can re-occur a few years later, especially under the stress of practice and/or the game.
This is a worry of mine. My boys love sports and participate is several. I have a heart condition and is known to cause sudden cardiac death is young athletes. I struggle with this every sports season.
So far I've opted on the side of allowing them to continue to play. I let their coaches know, and never take them to the mass physicl day the sports programs set up to process the student athlete threw like cattle. They get their physicals from their pediatrian and sometimes from my cardiologist.
The other day as I was driving home from work, I was listening to WLS890AM out of Chicago. I had just tuned in so I didn't know exactly what the subject was, but the host was telling a story about an angry doctor he knew.
The doctor went into medicine because, like many doctors, he in his heart felt the desire to heal, it was what he was called to do.
However, this doctor, thanks to Medicare and other things, spends most of his time from 3pm until he goes to bed filling out endless red-tape style paperwork. This wasn't what he signed up for, so he shows up to work the next day frustrated, annoyed, and exhausted. Like many humans would under these conditions, sometimes his interaction with patients suffers.
This isn't an unusual case, by the way.
The whole point of this post is that maybe we should change things up to allow doctors to do what they were called to medicine and studied hard for years to do, doctor.
My last patient is scheduled at 4 PM. I'm typically not out of the office until 6 or 7 PM filling out useless paperwork for insurance companies. Our office has started to charge a small fee to recoup some of what has been lost through reimbursement cuts and rising costs of doing business. Your doctor's office, like any other business, still has bills to pay. Lights need to be kept on, payroll taxes need to be paid, and insurance premiums need to be paid. Unlike most other businesses, we have not traditionally passed on that cost to the consumer. We take what insurance companies think they should pay, and that's pretty much the end of it.
I've told my boys, who are now getting older and thinking about what they want to do with their lives, that there are far easier and less stressful ways of making a living than being a physician. Obviously, being a primary care physician I didn't get into it for the money (taking a different residency would have paid several times more than what I make now) but it's increasingly becoming a pain in the arse to be a doctor in this country.
Athletes have been dieing on the field for YEARS. This is not really news. That schools continue to accept the $20 school physical for athletes is covering THEM but not in the athletes best interest. Granted many of these conditions are hard to detect with anything short of a stress test but perhaps it's time they start insisting on them or open themselves to liability which is all the $20 physical is intended to?
Stress tests and EKG's have not been shown to reduce mortality from sudden death in teen athletes. The solution is not a high tech one. If doctors ask the appropriate questions, they may prevent SOME of these deaths.
doubtful. Just like ekgs, its not that helpful. I think youre incorrect about stress tests though--never tried on a large scale
Echocardiogram has been shown to be beneficial, but was deemed not worth it economically
School liability - in this area it is the responsibility of the PARENT to provide proof of physical ability to participate in athletic programs. In fact (without a physical exam) every student is required to participate in the Physical Education Classes in the Public Schools. The only way out of these classes - is for the PARENTS to provide a Doctor's Documentation that the student is medically/physically unable to participate.
It is not the responsibility of the Public Schools to set the standard for this proof of medical/physical ability to participate.
brickwall,
sounds IDEAL in an IDEALISTIC world. Then there is the reality of a suit happy ambulance chasing society looking for a quick buck. The school USES the "physical" to protect themselves by saying it's not their fault since the child PASSED the "physical." You and I both know it's not a real physical but everyone gives it the wink and nod because a REAL exam costs money and school is NOT for education in the three 'r' but an education in how to game the system and play sports so one in a million MIGHT make it to the pro's one day.
I am a dilated cariomyopathy (aka heart failure) patient. Most athletes that die of cardiac arrest or sudden death (which is MUCH different than a heart attack) are from cardiomyopathies. They are extremely deadly and if the athlete is asymptomatic it is difficult to detect. The golden medical standard for diagnosing cardiomyopathies is the echocardiogram (a sonogram of the heart). They are expensive and Drs. are hesitant to offer them, and insurance companies are even less likely to cover them w/o a family history. For the sake of your child or even adult athlete I would exaggerate my family history a little bit. What did mom, dad, grandma or grandpa die of? Say a cardiomyopathy, they aren't going to ask for a death certificate and ask for a echocardiogram. Please get it done by an echocardiologist in a major hospital, not by an everyday clinical clinical cardiologist that isn't used to reading echocardiograms. I almost died that way, when I was released from that clinical cardiologists care, being told that I only had gas, when the test showed I was obviously in heart failure. If all else fails, pay for one and at least you will have a baseline. You will be discouraged as only 1% of American patients have dilated cardiomyopathies, but if your athlete is in that 1% that test will be your best investment. I take my sons every four years for echocardiograms. Some cardiomyopathies are hereditary, some we don't know what causes them... it could be an earlier case of a simple virus like 5th disease or hand, foot, mouth disease that causes a cardiomyopathy and your athlete might not have one at the time of the test. The best blood markers? hsCRP and BNP. Cardiomyopathies are extremely deadly and often the first noticeable symptom is sudden death. In today's health-age, patients need to take their health care into their own hands. Make sure you have a copy of all your test results. By law the Dr. must give it to you... and understand it. EKGS and stress tests will not show cardiomyopathies. No one thinks they will be in the 1%, until they are in it. Go out and rent "Beaches" to get an idea of how cardiomyopathies can work. Make sure you have a box of tissues by your side.
Are you kidding me? Who pays for it? Who pays for all the premature births and NICU stays after a multiple pregnancy after IVF. Those costs easily run from $100k-$500k and then add in long term health care when there are long term complications. The major cost of medical costs is from the last week or two of a person's life, not from these kinds of tests. The cost of taking care of a heart failure (cardiomyopathy) patient in it's later stages is exorbitant. Caught early it's treatable with 2 little pills (Ace and Beta Blockers). Again, EKG and stress tests will NOT diagnose a cardiomyopathy.
Elizabeth, your story is probably one in a thousand, or ten thousand. Our medical system would go broke getting an echo on every student athlete. We unfortunately have to pick and choose what we're going to spend our health care dollars on. Do we spend it on the asymptomatic 14 year old, or for a mammogram on the asymptomatic 35 year old with a family history of breast cancer, etc etc? Lots of choices to make, which is why we need to practice the best evidence based medicine we can. It's easy to run up a gigantic tab when you practice medicine 'from the heart'. Unfortunately, we can't afford to do that anymore.
I love how everyone talks about how expensive health care is getting and how it is ruining our economy. And then the same people seem to think it is reasonable to get a stress test and echocardiogram done on every 12 year old who wants to play sports.
Danny since these CHILDREN are going to be STRESSED, a $20 physical just doesn't cut it. Hell for that price it barely gets the basic vitals which is something the school nurse could do as part of their job. If it weren't for liability of the school they wouldn't even insist on a DR performing the physical. Yes that stress test sounds expensive until it is YOUR child that drops over on the field. Then the lawyers get the money, the taxpayers pay and we have a dead child. Tell me what is more expensive if it is your child.
If he was MY 12 yr old, I'd eat rice for a week to pay for it. Life has NO PRICE!!
doesn't require a stress test right off. It requires an EKG and echo. If there is something seen then a stress and cardiac MRI, just like my kid...and she is worth every penny.
The physicals required by the schools are a joke. Here is my $20, listen to my heart, take my blood pressure and sign my form. My brother and I went through these all through middle school and high school. No one ever noticed my brother had an abnormal heart valve until he died suddenly at 39. Thankfully my pediatrician took this info seriously enough to send my children to a pediatric cardiologist. My son also suffers this defect. I am certain a sports physical never would have found it. That said, I absolutely feel that it is a parents job to seek out the best medical care. It is a schools responsibility to educate, not parent.
MI girl, I agree that it is the school's responsibility to educate not parent. That said, I DOUBT schools are willing to give up sports. I also doubt that MOST parents are going to spend the extra $$$ on a physical with higher standards than the school requires to participate in sports. As another poster stated they are factory process that takes the vitals and not much more.
Many parents see athletics as a way to get their child an opportunity to make $$$$ and move UP in society. Those same parents cannot afford the health care many times. There has to be a better solution than covering the school's collective backside with a warm and fuzzy physical that is less than a fortune. How could it hurt to require an EKG/ECG and charge $30 instead? As parents have said here, no price is too high for their child to live.
The physicals required by the schools are a joke.
You really need to get a clue - schools require proof of medical/physical ability to take part in sports - as certified by a Doctor. Schools don't decide the procedure the doctor uses to determine that eligibility. The parents and the doctor decide that - if there is any liability attached to that physical - it lies with the doctor and the parent.
If a parent wants more than a standard physical procedure it is their responsibility to arrange that with the Doctor - the school has nothing to do with that. If the school refuses to accept the physical certification as provided by the Doctor - they can be sued.
Brickwall. Just how much of a physical do YOU give for $20 when the assembly line in the locker room just wants to get on the field? We aren't saying ALL physicals are this LAME, just the "required" physical for school activities.
All the doctor is "certifying" is they meet the standards of the physical. Pulse, BP, temp, can you hear me, can you see to sign your name, did you give me the right money to sign my name?
I'm glad that awareness is finally happening. Congenital heart defects are far more common that people believe. Luckily, my youngest had his heart defect found shortly after he was born, and I know his limitations, but prior to having a child with heart problems, I was completely in the dark like a majority of parents. We believe that our kids can do whatever they want in life, and that is fine and the way it should be, but we also need to be proactive so our children aren't dying from things that are preventable. An EEG takes all of 5 minutes to perform and has a wealth of information on the little sheet of paper that gets printed out, a pulse ox test takes even less time. My older sons, when they start sports, will both get the same heart tests that their baby brother gets, because heart defects can go undetected for a life time, however they can kill in a second.
I am the lucky parent of a child that was diagnosed incidentally. She was havig intermttent chest pain at rest, and a dilligent NP sent us to a cardiologist. My daughter was a runner, even though her cardiac anomaly has ended her competitive running she still enjoys managing her track team, and is alive.
Look, it's terribly sad when any kid dies. It is. The reality is many more kids die from car wrecks, trauma not related to sports, drugs, etc, than die playing HS sports. In the big scheme of things, we're talking about a very small number of kids a year.
Now, the question becomes how much are we, as a nation, willing to spend to find those relatively small number of athletes who are at risk? If you truly want to decrease the number of kids dying playing HS sports, then make the EKG and echo a part of the pre-participation PE. The problem with that is you're going to eliminate a lot of kids from playing because of the cost.
In many doctor's offices, the pre-participation PE is a "lost leader". Do the PE on the cheap in the hopes that Mom will bring the kid back for his sore throat, ear infection, brochitis, etc.
This is a problem that we have wresteled with in primary care for a long time. If there was an easy answer, we'd have found it by now...
Doc J
You find a TEACHING HOSPITAL reasonably close to home and the high school or college makes an arrangement with the Cardiology Department to do the studies for a reduced cost.THEY ALL HAVE GRANT PROGRAMS THEIR MEDICAL STUDENTS AND INTERNS, BUT ESPECIALLY THEIR RESIDENTS AND FELLOWS WORK UNDER!! Doing the studies will give the students, interns and fellows the added experience in the program they need. Don't say it can't be done unless you look around. I've been watching for 15 years for the topic to come up where I could reach a lot of people and tell MY story.
There is no data that routine ECG's and ECHO's prevent sudden death in teen athletes. Wishful thinking, but no data.
there is data supporting echo
Primary Care Doctor,
While you may see it as a loss leader, I'm not sure how many doctors are looking for actual patients. Unless I schedule MONTHS in advance I can't get a visit for illness in under 10 days typically and then I only see the DR for MAYBE 10 minutes and that is for an annual physical even. Perhaps it is because of all those LOSS LEADERS? How much does a EKG cost? Surely not the $99 I see advertised/charged to insurance.
By that statement you support the fact that the pre-participation PE meets NO preventative standards or diagnostic value other than advertising for the DR and CYA for the school. Was the athlete able to navigate their way to the exam, are they still breathing, do they have a pulse?
Yes some have a history section. SO??? do you think a child knows what to put down, or will honestly list something that would prevent them from participating?
All high school and college players should be given a stress test and an EKG before being allowed to play any sport. Liability is one thing but if you are really looking out for that childs well being the test should be required with out anyone telling the school boards.
Jim,
I don't have any problem with that...
My question to you is: Who pays for it?
Not good enough. (See below) Only ECHOCARDIOGRAM diagnoses cardiomyopathy.
"Sudden death" on a basketball court is MOST likely from CARDIOMYOPATHY, the usually unexplained enlargement of the heart. I was the Administrator at Childrens Hospital of Los Angeles for over 10 yrs. Two of my Pediatric Cardiologists worked on this. One requested a grant from the government and the same year he was turned down grants were given to the Queen of England to study the sperm of her race horses in this country, another in sexual habits of laboratory mice!! GREAT PRIORITIES!! But I did see results. One 4 yr old went from a wheelchair to a Little League uniform in a couple years. They did a microscopic biopsy of his heart by catheterization and cultured the tissue in the lab, determining what antibiotic he was not resistant to, and he was cured. So their theories work. But this can come from a flu a year ago, or an abcessed tooth 3 yrs ago. And it is NOT related to family history. The ONLY diagnostic tool is ECHOCARDIOGRAM, not ELECTROCARDIOGRAM. The physical exam, ESPECIALLY HEART, in high school boys needs to be UNIFORM and more thorough, and even MORE SO for college.
Jean,
Again, I have no problem with making echos part of the PPSPE...
My question is: Who pays for it?
I will tell you that it's all some parents can do to scrape up the money to pay for the physical is it presently exists.
Go back 6 entries
Everyone needs to google NICK OF TIME FOUNDATION. This is exactly what they do, set up testing sessions in local schools, businesses, etc., and run testing sessions. They have saved many lives! Started in the the Seattle area, but spreading across the nation. CHECK INTO THIS! IT SAVES LIVES AND AVOIDS THE HORROR AND TRAGEDY OF THESE SENSELESS DEATHS!!!!
Jean and Dr J,
We all want the best for our patients and children. These are minimum tests to clear students for participation in sports. This helps reduce the morbidity and mortality rates of participating, it is not a guarantee of safety. Parents are allowed and should be encouraged to seek further examinations at their own cost to HELP ensure the safety of their children. These further exams will not preclude them from injury or death but may help identify those exceptional few that may be at heightened risk. As with all of life and freedom, if you are not willing to accept the risk, you may choose to withold participation. Others are not obligated to pay their hard earned dollars for your child to participate. Sport participation is not a right, it is merely an opportunity. I encourage people to seek the best evaluation they can afford and make their decisions based on the results they garner. However, since participation in sports is not required and the rate of morbidity and mortality are small, it seems that sports should be allowed to continue and that the populace should not be required to pay to protect them from their voluntary particpation in them.
Dr T
Good for you Dr. T. You neglected to add that there is no hard data that routine ECG's and ECHO's reduce mortality from sudden death in teens.
I would be much more worried about car accidents, gun accidents, and suicide. Those claim thousands more lives than sudden death in athletes and are often preventable.
echo does...if i had time id find the data
Most deaths are due to hypertrophic obstructive cardiomyopathy, which is readily apparent on echo
So in an era where more and more people can't afford basic health care, you would propose doing echocardiograms on all teen athletes? The yield is so low that no responsible professional organization of sports medicine physicians agrees with you. Not only that, but there is no solid data that echocardiograms would prevent sudden death in athletes. "I know its true" just doesn't cut it when you are proposing spending billions of dollars.
Jumping
Simple answer YES. If you want to participate in EXTRACURRICULAR activities then you need to prove you are physically capable. or isn't your childs life worth $80 or so dollars? One EKG screening to cover the entire time a child is in high school sports, unless something is detected of course.
The yield may be low until it is YOUR child.
trust_verify, EKGs do not readily pick up HOCM. Only an echo does. Echos are more expensive than EKGs. Insurance companies balk at as much as they can, and they will certainly balk at an echo for a routine screening. You are thinking with your heart, not with your head. This is what politicians in D.C. have done and look at the financial mess we're in.
I am the mother of a fortunate high school athlete. My daughter who used to run track, was having interrmittent chest pain at rest. During a regular visit to the doctor, she let the NP know her symptoms. Subsequently we were refferred to a cardiologist. My daughter underwent an echo and EKG. She was found to have an anomolous RCA, and underwent further testing. She no longer is allowed to run, but is alive. She is not thrilled but stays involved by managing her track team.My kid is lucky, every student should be screened!
Short statement, My nephew died from a heart attack. He played in all the sports at school No physical that year. He died 6 weeks after he graduated, massive heart attack, drowning. We as a family, his Mom, Dad, had no clue. They changed the physical forms the nest year. Asking any sudden death in your family, that was new on the form. We miss Jacob, and we wish we had known.
Even worse, many of these kids are on Adderall or other stimulants which only increases the risks.
JeffJam:
You have a point. However, you must also consider the very elevated risks of accidents in kids with ADHD (hyperactive type). Without medication, these kids are highly impulsive. They run in front of traffic, jump out of trees, etc. As teens, they gravitate toward thrill seeking sports: Racing cars, parachute jumping, ski jumping, etc. The number one symptoms of ADHD in adults? Traffic violations. People who have a short attention span, poor planning, impulsivity, and crave stimulation make utterly terrible drivers. Personally, I don't think that people with severe ADHD should drive a car unmedicated any more than a person with epilepsy should drive without Dilantin. Ritalin, Concerta, Adderol, and others, have almost certainly saved tenfold more lives than they have taken. However, it is important to note that Adderol is specifically contraindicated in persons with fetal alcohol (who may have heart defects) and those with any form of heart disease. About 5 years ago, a total of 12 children had died after taking Adderol; 9 of these 12 children had a pre-existing heart condition.
Don't forget to turn your head and cough... ;{
Our son when getting his yearly sports physical always is told he has "White Coat Syndrome" which means he exhibits elevated blood pressure in a clinical setting. We always go back to the Pediatrician and to evaluate the results and they say hes fine. We asked for a referral to a pediatric cardiologist just to make sure, however our pediatrician says its not needed since his Blood Pressure is always in the normal range during his other Drs appointments. Makes me want to take him in just to be sure since hes now 15 and Im reading this article.
Why don't you buy a small home blood pressure monitor and use it to check your son's blood pressure at home? That way when his blood pressure gets high in the doctor's office you can tell the doctor what his readings were and compare to see if he really does have white coat syndrome or if it's something more serious. This works out pretty well at my house. My dad has high blood pressure and my mom and I both have white coat syndrome, so if either of us has a doctor's appointment Dad will take our blood pressure the day before. If Mom or I read high at the doctor's office the next day, we tell them what our reading was the day before and the doctor confirms our white coat syndrome. Despite the different circumstances you mention, it might still help you and your son.
Beaumont Hospitals in Michigan has been doing something about this for the last five years at least. They have a program they offer free of charge to participants. Basic screening of blood pressure and a 12 lead EKG is provided. Onsite cardiologists read the test and determine if an ECHO is needed. If so, that is provided as well. All free of charge. Patients with 'positive' clinical results, cardiomyopathy, tumor etal, are directed to follow up with their primary care physician.
Since being diagnosed with WPW over 30 years ago, and having it corrected via a cardiac ablation in 1983, I have tried to convince doctors that there needs to be an organized program of screening teenage athletes for this and other heart conditions.
WPW typically lies dormant and unnoticed by many doctors, in athletes until they push themselves to the limit of their capacities and there occurs a short-circuit in their cardiac electrical system. Often death occurs and it looks like a heart attack.
If athletes could be screened for this and other conditions, I believe many sudden deaths on the "field-of-play" can be avoided.
I agree with:
Jean Turner-1799360
It is also a parent's responsibility to look out for the health of their child. Schedule your annual sports physical for your child. Parents should research all new data and health related research into children sports medicine. Your child's peditrician should also specialize in Sports medicine as well. I personally asked our peditrician to have an EKG performed on all of my kids even as young as 7 (as a baseline). We found that my oldest son (13) has a level 1 Heartblock. He can continue to play sports but he does have a simple restriction which his coaches are aware of, constant hydration. Without the hydration, he can become physically exhausted which leads to pressure on his systems. But, he can still physically outperform other players. Even the coaches state that he doesn't look sick or act sick.
My point is, parents look out for your parents. Our doctors are only human and they may miss things. Be your players advocate, don't miss anything.
I forgot to mention after the EKG results my son has seen a pediatric heart specialist for further testing as well as annual monitoring.
I am a mother of four wonderful children and two have been diagnosed with a heart condition. My 6 year old daughter was diagnosed when I was 7 months pregnant her heart condition was more severe than my son. My son was 12 at the time he was diagnosed (April 2011) with AV Heart Block. He has been very athletic since age four he plays competitive baseball and football. Yes, his involvement in sports is voluntary and costly just as the insurance premiums I pay every month and the bills that my insurance does not pay to ensure my children get screened properly by their PCP and specialist.No one is stating that an ECG and echo will prevent mortality but it allows a parent and patient to be aware of the condition. These tests are able to detect heart conditions that a "regular physical" can not. A PCP should ask routine questions during a physical about how an athletes body reacts to physical exertion, not just sign the form and say here ya go you are good to play. As a parent I would much rather be aware of the underlying condition than find out after my son has collapsed on a field some where. There is accountability not only as a parent but the doctor who signs off on a physical form that did not ask the appropriate questions a pre-teen or teenager may not easily disclose to their parent but may to a physician.The night I took my son to ER the doctors were questioning me about why I had not looked into my son's chest pain sooner. The truth is my son never told me he was having chest pains for the past year before being diagnosed. He never displayed or complained to me of chest pains, shortness of breath, or being lightheaded. When the doctors turned to him to ask why, all he could say is he was scared having watched his little sister go though two open heart surgeries. He also said he did not want anyone to look at him any different as an athlete or person. Children may be embarrassed of the attention they get form having a heart condition and do not want to be treated any special way. They have to accept and cope with the news of their heart being different. I have watched the effects of this with my daughter who was born with it, she lives no different, she knows no other way. My son had a very hard time at first, he wouldn't discuss it, and he hid his emotions about it because that was his way of coping. I have been able to see both angles and I am thankful for ECG and echo tests and feel that not only should a PCP properly discuss family history and how their body feels during and after intense cardio workout with their young patients but they also ensure they are referred and seen for further screening. People want to always bring up the cost....what does the health of your child cost to you?? What does your own health cost to you?? When you have chest pains I am sure you go in and get it checked out but there are individuals on here that want to write….my question is who pays for it….
.my question is who pays for it….
The question back at you is pay now or pay later? I don't mean to be rude/crude here but if COST is a factor, a funeral is only about 6 to 10 thousand dollars and is a one time expense. I'm not sure what the uninsured cost of an ECG/EKG/ECHO is and I am quite sure the long term care should something be found is quite a bit more. That said tell me what it is WORTH. Medical care is COSTLY. POST illness/injury is much more expensive than early detection/prevention. Football helmets can be expensive but I think we all agree that that cost is far less expensive than head injuries.
Let me ask this of parents... are you willing to WAGER on your childs life? an ECG/EKG is less than $100 while an ECHO is 300 - 1500. I am NOT a physician but from reading I believe an ECHO is only warranted if the ECG/EKG or family history indicates a need for further study. Is that $100 something you will WAGER your childs life on? Again not being a doctor but I would think that ONE ECG/EKG that shows a clean bill of health would suffice for childhood and perhaps one at college if the youth chose to continue sports at that time.
TALK with your childs physician.
It is interesting to read this. In Ontario (Canada), no physicals whatsoever are required for a child to play sports at school, at least not in our area, and in fact I never heard of this before. Thinking back, some of the workouts were just brutal, in very hot weather, especially in field hockey. I wonder if the rates of sudden death are similar in the US to Canada?
Picha I would GUESS that it is MUCH harder to SUE the schools in Canada. I also don't know how thorough Canadian medicine is about screening EVERYONE much earlier than the American system. You might already benefit from some level of screening/tests that look of early symptoms/indications of heart issues in the population, not just those who request them.
Medical expenses are costly and what I am saying as a parent is that it is a cost well worth it! My son and daughter’s heart mean more to me than anything out there that money can buy and as someone stated earlier, they would eat rice for a week, I would eat rice for a lifetime if it meant my children receiving treatment and screening as needed. I happen to know that the cost on my son’s echo was close to $1000 when I reviewed the EOB from the insurance company. The $400 I had to pay out of pocket gives me peace of mind to be able to have his diagnosis. The surgery my daughter had at 11 weeks old was near 70K, the second surgery she had at 4 years old topped 100K, so you are preaching to the choir when you want to say pay now or pay later. And you are correct in stating that an echo is performed if there are abnormal ECG readings detected, an echo is a more in depth look at the heart and its functions.
Personally, I talk with my children’s doctor and cardiologists and they are rather surprised at how much I research and know on my own. Because as a parent once the doctor does his or her job in testing, screening, diagnosing, it becomes my responsibility to educate myself and my children even further.
The cost factor….well let us not forget all those that do not have insurance and live off taxpayer dollars for other health issues like those alcoholics who are seen at the local hospital to be diagnosed with cirrhosis then walk right out and head straight to the liquor store for a twelve pack….and they are grown adults….who pays their bill??? Better yet who is complaining about paying their bill? Then who pays for their one time funeral expense because chances are they have no life insurance to cover that cost.
They are foundations that will help those that are less fortunate to get the proper screening if needed. There are options out there for those that seek it. I think what parents are saying here are they are willing to pay, they are willing to support screening in their young athletes for the sake of knowing.
That translates into 175 to 233 deaths each year among high school athletes.
Sounds like a statistic not based on fact - what is the actual number of deaths - one that is not translated from some questionable estimate?
Also - sounds like someone is trying to improve medical profits by calling for more expensive (un-necessary) tests.
Thank you, Tina! KEEP UP THE WONDERFUL MOTHERING!!
Wrong Jean,
Most of these problems, if not all, are congenital and have nothing to do with how you take care of yourself. As a matter of fact, Sudden Cardiac Death occurs to healthy young athletes.