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The Athletic Heart: Who to Screen Who to Bench?

Posted 4/29/2016 by UHBlog

The key to preventing heart disease is managing the risk factors. We can help.

The Athletic Heart: Who to Screen? Who to Bench?

We've all read stories of high school and college athletes dying suddenly after playing sports. Although rare, athletes of all ages have experienced sudden death on the playing field from previously unknown heart problems.

That's why early screenings are so important, says cardiologist George Farah, MD.

“Before playing a sport, athletes should first see their primary care provider for a routine check-up,” Dr. Farah says. “Their primary care provider should be listening to their heart and taking a complete personal and family history as a start.”

One of the symptoms your doctor will listen for is an unusual heart sound, known as a murmur. This can be an indicator of structural changes in the heart and should be investigated further, Dr. Farah says.

Your doctor will take an in-depth medical history, which will include information about your relatives. If anyone in your family has died suddenly for any reason at an early age (under 50 years old) or there are any congenital heart defects in your family, you're likely to be referred to a cardiologist for further testing and evaluation.

You’ll also be asked about cardiac symptoms that you’ve experienced, either before, during and/or after participating in sports. Among the symptoms that could indicate a heart condition are:

  • Shortness of breath
  • Chest pains
  • A “racing” heart feeling
  • Excessive fatigue
  • Light headedness
  • Dizziness
  • Passing out

If you have any of these symptoms, you should contact your doctor or call 9-1-1 immediately.

“With any athlete that has symptoms, abnormal exam or a concerning family history, we would consider doing both an electrocardiogram (EKG) and an echocardiogram (echo),” Dr. Farah says. “The first – an EKG – checks the electrical system of the heart. The second is an ultrasound of the heart where harmless sound waves are bounced off the heart to find any changes in its structure.”

If you pass out or have an abnormal EKG or echo, expect to be benched until you can be evaluated by a cardiologist.

Some countries and athletic organizations suggest everyone get a screening EKG before participating in certain sports. But, says Dr. Farah, this is controversial because of the costs involved and concerns that false positives could inappropriately exclude you from participating in athletics.

For now, the best indicators that an athlete may have a possible heart problem are your symptoms, family history and a physical examination that includes listening to the heart.

“Of course it depends on the diagnosis, but it's possible for someone with a heart condition to continue playing sports,” Dr. Farah says. “Our goal is always to get the athlete back into their sport if it can be done safely.”

George Farah, MD is a cardiologist at University Hospitals Harrington Heart & Vascular Institute at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Farah or any other University Hospitals doctor online.

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