Screening for Heart Defects May Prevent Juvenile Deaths

A novel screening approach that includes a questionnaire, resting electrocardiogram (ECG), and a screening MR (S-MRI) may be beneficial to young athletes. This technique is cost-effective and may prevent sudden cardiac death (SCD) in this population, according to a study presented at the American College of Cardiology 2017 scientific session.

Pre-existing heart defects may lead to SCD in patients during strenuous exercise, such as sports. Student athletes typically undergo a review of medical history and a physical to evaluate an individual’s health prior to participation. However, with current methods, some young athletes may be at risk of SCD due to undetected cardiovascular abnormalities.

The authors said that the exact incidence of SCD in population-based studies is currently unknown, and high-risk cardiovascular conditions (hr-CVC) is not well defined. This study is the first to attempt defining high risk for SCD by using prevalence data.

In the study, the investigators used their newly created screening approach in 5255 children aged 11 to 14. They discovered that health history, a physical, and an ECG were unable to identify hr-CVCs and their severity, according to the study. Through s-MRI, numerous abnormalities were discovered.

The authors found that the most frequent abnormality was an ECG defect, which was found in 40 participants. They also found an anomalous origin of the right coronary artery in 23 participants. Another 15 patients were discovered to have cardiomyopathy, with 12 having dilated cardiomyopathy.

The authors also conducted a quantitative MRI in 1159 participants to determine left ventricle mass and left ventricular end-diastolic volume, according to the study.

These findings support the use of this screening approach to discover prevalence data for the general population. Additionally, the findings suggest that it can be used to successfully screen youth for participation in sports or strenuous activities.

"It is safe, accurate, comfortable and likely cost-effective,” said lead investigator Paolo E. Angelini, MD.

Further studies are needed to determine how the screening approach could be used to prevent SCD in young athletes, according to the study.

"Cost effectiveness of such an approach to prevent sudden cardiac death has not been demonstrated," said Kim A. Eagle, MD, MACC, editor-in-chief of ACC.org. "It is important to determine how many student athletes may be excluded from sports participation for conditions or findings that may or may not really represent a major threat." He added that this study is "hypothesis-generating, not conclusive."