Should ECGs be required for student athletes?

Reply Thu 5 Jan, 2012 10:19 am
Today's paper reported (yet another) middle school athlete having a heart attack during sport's practice.

Because this was a 14 year old boy living in Oregon I immediately wondered if he was on medication for ADD/ADHD, having remembered reading about a link between the heart failure and stimulant medications some years back.

So I started poking around......

I came across this: http://circ.ahajournals.org/content/117/18/2407.full

I was surprised to learn that Japan and Europe have required ECGs for all student athletes for nearly 30 years but that such a program is

“impractical and not applicable” to the American system because of the financial resources, manpower, and logistics required for a national screening program.


In a study of 5615 young athletes in Nevada, the sensitivity of the ECG in identifying serious cardiovascular abnormalities was 73% versus 4.5% for history and physical examination

In relation to ADHD the report says

ADHD may be more prevalent in children with heart disease than in the general pediatric population. Mahle et al30 have reported abnormal attention scores in 45% of children and abnormal hyperactivity scores in 39% of children with heart disease based on the responses of parents and teachers on the DSM-IV Rating Scale and Behavior Assessment System for Children. In this study, more than two thirds of children with hypoplastic left heart syndrome were thought to have attention/hyperactivity problems. In 2004, Kirshbom and colleagues31 found that 50% of children with total anomalous pulmonary venous return displayed abnormal hyperactivity and/or attention deficits. As previously noted, chronic or intermittent hypoxia experienced by children with heart disease has been linked to adverse effects on development, academic achievement, and behavior.25 Congenital cardiovascular anomalies are present in 76% of children with velocardiofacial syndrome/DiGeorge syndrome, caused by 22q11 microdeletion.32 ADHD affects 35% to 55% of these children

Every year Mo has to have a sport's physical. An ECG has never even been suggested, which, considering we don't even know his full medical history, seems strange. I'll be requesting one when he has his next sport's physical.

Has a doctor ever suggested/required and ECG for your young athlete?

Do you think they should be required for all athletes?

Do you think they should be required to athletes taking stimulant medications?

Do you think they should be required for all children?

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Reply Thu 5 Jan, 2012 10:23 am
If them boys ain't ready to take one for the team, including bein' willin' to die for the team, they got no business goin' out fer sports.
Reply Thu 5 Jan, 2012 10:24 am

Never been suggested, no. I think I might bring it up too.

Required for all children -- probably. I'd like to know more about the financial resources, manpower etc. though.

One thing that I wonder about (I don't know) is just the numbers involved. How many children in Europe and Japan play organized sports compared to American children?
Reply Thu 5 Jan, 2012 10:29 am
Yep.. there is no "I" in heart attack.
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Reply Thu 5 Jan, 2012 10:31 am
A lot of the stuff I read made a distinction between recreational sports and competitive sports, and discussed a condition called "athlete's heart" which can develop after years of extensive training.

ADD drugs can aggravate any heart condition so I imagine if someone was taking these drugs for years and developed "athlete's heart" that there could be some serious problems.
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