Heart Screen

Browse by Age Group • Aug 22, 2023

Back-to-School: Does your Teenage Athlete Need a Heart Screen?

Last week we looked at the differences between back-to-school sports physicals and well child exams. This week, we are discussing if your teenage athlete should get a heart screen in addition to their sports physical. Recent reports raise questions among parents about whether they should screen their teenager for cardiac anomalies before participating in youth sports.

The sudden death of an otherwise healthy young athlete is a paradox that is tragic and difficult to understand. Over the past 30 years, a number of cardiac conditions have been identified that can lead to an athletic sudden death. These diseases include genetic disorders affecting the heart rhythm and structure and congenital anomalies of the pathways of the main coronary arteries.

Identifying these entities before such a tragedy occurs has been a goal that many physicians worldwide have attempted. Most of these efforts involve screening programs that include an EKG. This type of program has occurred in Italy for many years. These screening programs have been included in the evaluation of athletes in Europe and for the Olympics.

These types of screening programs have not been embraced in other areas of the world, including the United States. Part of the problem is that athletic training and ethnicity can lead to the same kind of abnormal EKGs that would otherwise be observed in heart disease.

Current American Heart Association guidelines for athletic clearance specify important points in the athlete’s medical history and physical examination. These are to identify potential red flags requiring more intensive evaluations. These red flags include a family history of cardiac disease in young (< 30 years of age) family members and abnormalities of cardiac examination.

Many practitioners will likely add EKGs to their athletic screenings or sports physicals. The true effectiveness of this strategy remains uncertain. However, if they obtain such EKGs, their interpretation is extremely important. The physicians who interpret should clearly understand that athletes often have abnormalities in their hearts due to their athletic training. These training-related abnormalities occur much more frequently than the incidence of the very rare disease that leads to sudden death in young athletes.

If you have any concerns about whether or not your child should get a heart screen in addition to their sports physical, be sure to talk to your pediatrician. St. Louis Children’s Hospital’s Young Athlete Center also provides comprehensive care for young athletes, including preventive care.

In case of a cardiac emergency with a child, determine where the nearest accredited, Level I pediatric trauma center is located. St. Louis Children’s Hospital has six pediatric ER locations across the St. Louis and southern Illinois region. These include St. Louis Children’s HospitalChildren’s Hospital at Memorial Hospital BellevilleChildren’s Hospital at Memorial Hospital ShilohChildren’s Hospital at Missouri Baptist Medical CenterChildren’s Hospital at Northwest HealthCare, and Children’s Hospital at Progress West Hospital.

Sports Physical for Your Child

If your child plays school sports, they will likely need to have a sports physical. Health plans often do not cover sports physicals and do not meet quality metrics around annual wellness. Most insurance companies will, however, cover your child’s yearly well child exam. For example, when they document the visit as a well child exam, most insurances will cover immunizations. But if they document as a sports physical, they will not. This, of course, depends on your individual health policy.

For more information, contact your insurance company or primary care provider for complete policy details.

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