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Sudden death in young athletes—can it be prevented?

Posted By Patrick J. Skerrett On March 15, 2011 @ 1:26 pm In Children's Health,Exercise and Fitness,Health,Heart Health,Prevention | Comments Disabled

In a recent seven-day span, three high-school athletes died suddenly while pursuing their sports.

  • March 3: Wes Leonard, a 16-year-old basketball star from Fennville, Michigan, collapsed after sinking the winning basket to clinch his team’s undefeated season.
  • March 8: 16-year-old Javaris Brinkley of Littleton, North Carolina, collapsed while playing basketball at a local church.
  • March 9: Sarah Landauer, a 17-year-old from Gainesville, Florida, collapsed during track and field drills at her school.

This may look like an epidemic, but it isn’t. Approximately 100 youth, high school, and collegeathletes die each year, more than half of them from a hidden cardiovascular problem. The recent string of deaths has renewed a hot debate among parents, coaches, and physicians: should the pre-sports checkup for competitive athletes include an electrocardiogram (ECG)?

On the pro side: Adding an ECG to the check-up will identify a few more athletes with potentially dangerous cardiac conditions. If a simple ECG can save lives, then it makes sense to do it.

On the con side: ECGs won’t detect all athletes at risk. In addition, they will mistakenly indicate that some perfectly healthy athletes have cardiac problems. The cost of adding ECGs to pre-sports check-ups is another barrier. As I write in the May 2010 Harvard Heart Letter, the American Heart Association estimates it would cost at least $2 billion a year.

Contradictory studies offer no clarity. A large study from Italy showed that adding ECGs saves lives, while a new one from Israel showed they make no difference.

No easy answers

As a parent of a basketball player and a dancer (one of my daughter’s tee-shirts says “If ballet was easier it would be called football,” and I believe it), I want every possible reassurance my children will be okay.

As a health writer, I know that we need to put our limited health care dollars to best use. Spending $2 billion on pre-sports ECGs to save 100 lives comes out to $20 million per life saved.

In the abstract, it’s easy to say that’s way too expensive, and we would be better putting this money into more cost-effective prevention and treatment strategies. But if one of those lives saved is one of my children, I’d pay it in a heartbeat.

And there’s the conundrum of modern (expensive) medicine—what’s good for the country and the health-care system isn’t always what’s best for the individual.

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