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Posted: 3/10/2011

For a week news of the two teen athletes that died in quick succession has captured the nation’s attention.  Wes Leonard, the 16 year old basketball star at Fennville High in Michigan, hit the game winning layup to preserve an undefeated season and then collapsed on the gym floor.  He was lifted up by his teammates in celebration as fans stormed the court before Leonard’s coach, Ryan Klingler, heard someone yelling for help. It was the kind of call where you know something is really wrong.  Paramedics were called and performed CPR as the young athlete was rushed to the hospital, but he died on the way to the hospital.

Less than 72 hours later another athlete, Matthew Hammerdorfer, died after a rugby match in Colorado.  Hammerdorfer, a 17 year old junior at Poudre High School in Fort Collins, Colorado took a hit to the chest in a Saturday rugby match and stopped breathing.  As with Leonard, emergency crews responded quickly, but Hammerdorfer’s heart had stopped beating and didn’t respond.

Both boys died of sudden cardiac arrest caused by an enlarged heart.  The fact the accidents occurred so close together was a matter of happenstance, but seeing two young men so full of life and vitality fallen so quickly to undiagnosed heart conditions in the middle of athletic games has raised more than a few questions and concerns.  

Is heart disease among young people becoming more prominent due to health or environmental hazards? Is the accident ratio increasing among young athletes?  Are there simply more athletes playing more sports than in the past? Could more be done to prevent these accidents? Should heart screening be mandatory in schools for participation in sports? Should AED’s (automated external defibrillators)be more easily accessible at sporting events?

The questions go on and on.  And, the answer really is easy. Yes, if there’s anything more to be done, it should be!  If students are more prone to heart conditions because of poor diet or environmental toxins, we should work to correct both.  If more AED’s are needed on school campuses, they should be placed there.  If more sporting events need to have a cardiac responder or EMT in attendance, we should begin working to ensure the necessary personnel are provided. If heart screening would help athletes live, it certainly seems sensible to provide it to the extent that it’s possible.

Whenever widespread school related policies are discussed, administrators and congressman alike start seeing dollar signs along with visions of a rising national debt.  However, as the saying goes, safety really should come first and perhaps making these kinds of national mandates possible is a matter of value and creativity.

While the American Heart Association (AHA) – the agency in charge of advocating heart health – has not backed the notion of required heart screenings because of the cost and the number of students it would inhibit from participation due to a test that can – at times – provide a wrong diagnosis. However, the primary issue is the expected cost and logistics of putting such a mandate in place throughout the country.  Essentially, the cost is weighed against the projected value and the cost, so far, has won.

However, screening athletes with an electrocardiogram may be more cost-effective that many realized, and more effective then they hoped.  For almost 30 years, the Italian Ministry of Health has required competitive athletes to undergo EKG screening prior to competing and tracking the results. The screenings resulted in a 89% reduction in the rate of cardiac deaths among athletes 14 to 35.  Based on those numbers, the International Olympic Committee recommended EKG screenings for all competitive athletes.

A study published in the Annals of Internal Medicine proposed that heart screening for athletes 14 to 22 would only cost an additional $89 per athlete - compared to screenings with only a medical history and physical examination – but save 2.06 more life-years per 1,000 athletes (a metric used to measure the effectiveness of medical practices).  Considering that a typical cardiogram usually costs around $500, the noted affordability for athletes was encouraging, but is it enough?

It’s not that the AHA doesn’t advocate heart screenings, they do, but the issue to some is simply more complex.  One writer insisted that it would probably be considered discrimination to only screen athletes, so requiring screening for athletes may involve screening all 75 million American children and teens. Others have contended that since around 90% of the cardiac fatalities in student athletes are males, requiring screening for all athletes doesn’t make sense, even though there are numerous cases each year of female fatalities.

The debate remains simple for many, though.  Young lives could be saved and if the saving is possible, it should not be optional.  One school already using EKG screenings, reported a per student cost of under $30.  If you can save a life for 30 dollars, it seems as if this is a minimal cost to screen students compared to the arguments present by other health entities that claim that the costs to perform heart screenings would not be cost effective.  Of course there are many ways to review the argument of performing heart screenings on athletes, but an answer to the arguments may require some creativity, logistical savvy, and political working, but in the wake of Wes Leonard and Matthew Hammerdorfer, perhaps America’s ready to begin the task in earnest.

Many local and online medical supply retailers are offering AED’s and CPR training courses for schools at discounted prices, such as Heart Safe America and AED-SHOP.com  (www.aed-shop.com).   Increasing defibrillators and cardiopulmonary training may effectively reduce the lives lost from cardiac arrests, but the measures still fail to prevent accidents from occurring in the first place.

Incorporating heart screenings is the best idea so far for combating the root cause of the issue, but the process is sure to proceed slower than proponents would hope. For now, school-based and independent athletic organizations can encourage heart screening for athletes and be sure AED’s are accessible during athletic events.  The technology exists to prevent the death of more young athletes. Hopefully we, the people, will take action in time.

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