ECGs as Part of Back-to-School Testing

Trends are changing to catch potentially fatal heart problems early.

At least for high school and college athletes in competitive sports, more schools are including electrocardiograms (ECGs) in their physical exams. ECGs look at the heart’s electrical system and pick up any abnormal patterns or rhythms that should be further evaluated.

“It’s a good start,” says Dr. Robert Myerburg, an electrophysiologist with the University of Miami Health System and Miller School of Medicine. “While it makes perfectly good sense to test these athletes, there is increasing attention to the question whether screening ECGs should be done on everyone — and much earlier.”

He says Japan has been including ECGs in school physicals for children entering the first grade nationwide for many years. Then in the seventh grade they test them again to pick up conditions that may have been missed the first time around.

Silent Congenital and Inherited Heart Conditions

The incidence of hypertrophic cardiomyopathy (an abnormally enlarged heart) is one in 500 individuals. It tends to show up after puberty and can be a risk factor for sudden cardiac death during times of extreme exertion.

Another inherited condition, long Q-T syndrome has a published incidence of one in 2000. However, says Dr. Myerburg, the Japanese are finding with all their testing that the actual incidence is closer to one in 1000.

A study from Italy showed that people with long Q-T syndrome that are not diagnosed or are diagnosed but not treated, have a 13% chance of dying by the age of 40years, compared to a three to four percent chance in the general population by the age of 40.  

“Given the potential risks involved, we should think carefully about screening all of our children for these silent killers,” Myerburg added.

“At the very least,” says Dr. Myerburg, “an ECG is a good idea pre-participation in high school and college competitive sports. It is curious that the 5 major professional sports in the U.S. do pre-participation ECGs on all of their athletes, and it is also a requirement of the International Olympic Committee.”

Written by a staff writer for UHealth.

Tags: back to school, cardiology, physical, Robert Myerburg