ECGs

ECGs

ECGs could save your child's life. Electrocardiograms (ECGs) record the electrical activity in the heart and can identify people who are risk for sudden cardiac arrest.

ECGs could save your child's life. Electrocardiograms (ECGs) record the electrical activity in the heart and can identify people who are risk for sudden cardiac arrest.

The study's lead researcher, Dr. Joseph Marek, founder and medical director of the Midwest Heart Foundation in Oakbrook Terrace, Ill. said "I think we should do this testing and find the kids who are at risk for sudden death and potentially save their lives,"
ECGs are especially important for teens who are going to take part in sports, he said.
"To me as a parent, this is a no-brainer," Marek said. "I think doctors should be recommending ECGs to their teen patients."

Not everyone agrees, however. One of the main objections to doing extensive ECG testing has been cost, but Marek said the tests in his study cost less than $10 each. For the study, his team raised money for the testing through community donations.
Marek said that some also feared that testing teens would swamp the medical system because the rate of abnormal heart rhythms among young adults was thought to be in the 10 percent to 40 percent range. But, he said, "our study shows that number is well under 3 percent," so that idea "doesn't hold water." "ECG testing of young adults is certainly feasible," he said.

Many physicians do recommend that children, particularly young athletes, have a  medical history taken, and the child or adolescent  receive a complete and thorough medical exam. This exam should include blood pressure measurements, and a careful cardiac exam looking for new murmurs.  Symptoms such as palpitations during exercise, visual changes, fainting while exercising or immediately after exercise, and chest pain should all warrant further evaluation.

Pediatrician, Sue Hubbard M.D. of Dallas, Texas says "The history that should be taken on any athlete who is being screened for sports participation should include a history of any unexplained or sudden death in a family member. Are there any family members with unexplained fainting episodes or seizures? Are there family members who had unexplained deaths such as drowning or single car accidents?   Are there any family members with a known genetic disorder that predisposes to sudden cardiac death?  The history should also ask about any fainting (syncope) in the athlete."

According to Marek's study more than 250,000 people die from sudden cardiac arrest, including an estimated 2,000 young adults.
"Sudden cardiac death in young adults can be identified before they have a catastrophe in a cost-effective manner by doing ECG testing." Says Marek.

Marek's research team gave ECGs to 50,665 teens, 14 to 18 years old, including athletes and non-athletes between 2006 and 2010.  The study was done in 32 schools, in Chicago, while the teens were attending school.

The screening identified 1,096 teens with abnormal ECGs, indicating a heart irregularity that could result in sudden cardiac death. Of those teens, 150 were found to have left ventricular hypertrophy, which can lead to hypertrophic cardiomyopathy, the most common cause of sudden cardiac death. Another 145 had a condition called prolonged QTc, which could indicate long QT syndrome, also linked to sudden cardiac death.

A similar study done in Italy over a 26-year period found that ECG screening cut the number of cardiac deaths by 89 percent, Marek said.

The findings of the study were to be presented in San Francisco at the Heart Rhythm Society's annual scientific sessions. Experts note that research presented at meetings should be considered preliminary because it has not been subjected to the rigorous scrutiny given to research published in medical journals.

Dr. Gregg Fonarow, the associate chief of cardiology at the University of California, Los Angeles, medical school said that "sudden cardiac death in the young can have devastating impact on families, care providers and the community."

Though some of the abnormalities that cause these deaths can be detected by screening ECGs, Fonarow said, "the routine use of screening ECGs in the young is controversial."
"Further studies of ECG screening are needed to evaluate the resource requirements, reliability, reproducibility, effectiveness of preventing sudden cardiac arrest and potential harmful effects of screening," he said.

If your child participates, or plans on participating in competitive sports, make sure he or she has a complete physical exam that includes a good family history. Also check to see if your school has an automatic external defibrillator available, and that there are trained personnel, on hand, that know how to use it.


 

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