When I saw this story today on the BBC News Health page, two simultaneous thoughts popped to mind: parents would be nervous and US pediatricians would once again have to defend our stance that EKGs are not needed as a routine part of youth sports health screening (a/k/a the pre-participation evaluation or PPE).
This issue, to screen or not to screen for heart disease with EKGs, is not new. This is one of the more deeply discussed and hotly debated topics in child health today. The topic gets discussed routinely but also when headlines rattle us, such as when 13 year old Justin McAfee, an Idaho baseball player, collapsed of a supposed heart attack this past spring while running the bases in a Little League baseball game.
When that story broke, I turned to one of the top pediatric cardiologists in the country, Dr. Reggie Washington from Sky Ridge Medical Center in Colorado, for answers. Dr. Washington told me:
- “True heart attacks (myocardial infarctions) are extremely rare in children."
- “The most common causes (of heart attack-like events) are not myocardial infarctions but some muscle issue with the heart”.
- “The American Heart Association and American Academy of Pediatrics are opposed to routine global screening for heart disease in athletes”. Instead, Dr. Washington explained that screening is done if a patient has symptoms or if there is a family history of heart disease.
Different countries do practice medicine differently. We often learn a great deal from our International colleagues but that doesn't mean that we are always going to agree. We have to make sure the means justifies the ends whenever we recommend a test for a child, or an adult. So far, EKGs are not a good screening test when the physical examination and family history are both squeaky clean.
So, call your pediatrician if you are concerned about your child's heart health. A good review of your family history with a complete examination of your child will help your pediatrician decided if your child fits the criteria for a more thorough heart screening. And, just in case, have all adults and teens in your home learn CPR. We all have to be realistic that heart health sometimes changes despite our best preventive efforts. As we learned with Justin last last spring, it really is a life saver.
For more information on heart health in kids and why you should learn CPR, click here.