Italy Has Screened Thousands of Young People for Heart Problems Playing Sports With an EKG and Says They Saved Lives

EKG Heart Screening Italy Has Screened Thousands of Young People for Heart Problems Playing Sports With an EKG and Says They Saved Lives

Electrocardiogram Screening for Heart Problems Student Athletes : Italy and at Least One U.S. Suburb Think EKG for Children is A Good Idea

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Should children in gym class and who play sports get electrocardiograms? While it will not detect many heart problems an ekg is a simple test of the heart's electrical activity where wires are taped to the chest and a brief recording of the heart's electrical activity is made. An EKG will detect some heart problems including some congenital heart rhythm problems. Student athletes for the most part participate in school sports without problems. But you hear from time to time about a child that suddenly collapses. Should student athletes and all children even those who are just in gym class get electrocardiograms as a heart screening tool? In the U.S the powers that be seem against it, some saying it isn't cost effective since so few problems would be detected yet in Italy, a program has been in place for years to electrocardiogram screen young people in sports and athletics and they claim they have saved lives.
Unlike Italy, in the U.S. routine EKG screening of children for sports has not been done. Italy does encourage young people if not children. It doesn't make sense to me that in Italy they are encouraged to get electrocardiograms and yet here in the United States they say young people don't need them.










There was an Italian study by the Center for Sports Medicine of Padova involving nearly 34,000 athletes under 35, in which 1,000 were disqualified from competing on health grounds - 621 of them because tests revealed relevant cardiovascular abnormalities.



The European researchers recommended heart screening should start around the age of 12 to 14 and be repeated at least every two years. Dr Domenico Corrado, of the Departments of Cardiology and Pathology at the University of Padova, Italy, one of the lead researchers on the study, said: "We know very little about the risk of sudden death associated with exercise in young competitors, so the benefits versus the hazards of sports activity pose a clinical dilemma".



"However, we know from a study in the Veneto region of Italy that adolescents and young adults involved in competitive sport had a two and a half times higher risk of sudden death." Back in 2005 a headline story started "European heart experts are calling for all young athletes to be screened for potentially fatal heart problems before they compete".

Call to Check Athletes' Hearts


Apparently it's a good idea for Italian kids to get ekg heart screening not for American kids, at least if you ask some of the U.S. medical community. I understand some of the U.S argument that EKG doesn't screen for all potential heart problems and a resting EKG is even less useful. Nevertheless, if you prevent some kids from getting hurt I think it's worth it. Apparently things are starting to change in the U.S now.




The Village of Lincolnwood, Illinois in suburban Chicago gives children electrocardiograms. "The Lincolnwood School District is taking a bold step to prevent that from happening to their kids. It is one of the first in the nation to require students be screened with EKGs before playing on a sports team. Electrocardiograms can pick up some potentially fatal heart conditions that a physical exam cannot.



"It seems like every other week you hear about a young athlete who collapses on the field with no apparent symptoms," said Paul Langer, the district board member who hatched the idea for the mandatory program. "You sit there with your wife and you say 'Oh my god, what if that was our child?' "

Signs of Heart Defects in Young Athletes Ignored

In Phoenix, Arizona Dr. Paul Steingard is a physician who has come to believe in the utility of EKG and screening for school athletes and has formed a group called TOPS, Team of Physicans for Students.

Team of Physicians for
Students

Cardiologists Call for Cardiovascular Screening for All Young Competitive Athletes

CLAMMY AND WEAK LIKE A HEART ATTACK THE MAN WITH THE ELEVATED CARDIAC ENZYMES NEEDED A MEDICAL DETECTIVE TO FIND OUT WHAT HIS HEART ATTACK REALLY WAS

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I read a fascinating story about a man in his early forties who had severe chest pain and all the signs of a heart attack. How can you tell if the chest pain is from a heart attack? YOU CAN'T. IF you have Chest Pain CALL 911 IMMEDIATELY for an ambulance. Let the doctors decide. Time is critical and it's better to err on the side of caution. Anyway,it's a big problem. You don't want to miss a heart attack but it turns out that many times chest pain can be due to another cause. This man was sweating and clammy and weak. He even had elevated blood cardiac enzymes like a heart attack. Many people think a normal electrocardiogram EKG means you don't have a heart attack. But you can have a heart attack or cardiac problem even with a normal EKG. Doctors look for chemicals, cardiac enzymes in the blood for evidence of heart muscle damage. This man did have elevated chemicals in the blood. It took a medical detective to figure out what the man with chest pain really had. It was not a heart attack but something much more mysterious. It turned out the answer was in his urine!




"When Decter (the doctor) heard that, something stirred in his memory. Cola-colored urine. Perhaps this was the key. Had he had this kind of dark urine since then? he asked. The patient told him that a couple of times a month his urine would turn brown and he’d feel achy all over. It happened whenever he was sick or tired or when he exercised too hard. He’d told lots of doctors about it, but none of them could figure out what was going on".



















"Decter knew he was on to something. Urine that dark is usually caused by muscle breakdown. When muscle cells are damaged, they leak CPK,( there are fractions of CPK that are more specific for heart muscle. There is also another chemical called troponin for heart muscle) but they also spill several other chemicals. One of them, the compound that gives skeletal muscle its distinctive deep red hue (myoglobin), can turn urine a dark brown. Were the brown urine and the elevated CPK caused by the same problem? Were they both signs of some longstanding disease process that was destroying this patient’s muscle"?



"Decter sent his patient to Dr. Alfred E. Slonim, a pediatric endocrinologist by training who spent his career investigating diseases of the muscle. The patient called Decter after seeing the specialist, almost speechless with excitement. Slonim spent more than an hour with him and his wife, getting the history of his strange illness. “Tell him about what happens on Yom Kippur,” his wife prompted near the end of the interview. Every year on the Jewish day of atonement, the patient would fast for a day, from sunset to sunset. And every year, he would spend the day after Yom Kippur in bed, crippled by an aching in his muscles and passing dark brown urine. Once he said that, Slonim had the diagnosis:".




He had a genetic condition called carnitine palmitoyltransferase II deficiency. Carnitine palmitoyltransferase II deficiency is a condition that prevents the body from converting certain fats called long-chain fatty acids into energy, particularly during periods without food (fasting). Carnitine, a natural substance acquired mostly through the diet, is required by cells to process fats and produce energy. People with this disorder have a faulty enzyme that disrupts carnitine's role in processing long-chain fatty acids.



The myopathic form is the most frequent and typically the least severe form of carnitine palmitoyltransferase II deficiency. It has a variable age of onset and is characterized by recurrent episodes of muscle pain (myalgia) and weakness. This condition is sometimes associated with the abnormal breakdown of an oxygen-binding muscle protein called myoglobin (myoglobinuria) so that the protein winds up in the urine or the breakdown of muscle tissue (rhabdomyolysis). Rarely, myoglobinuria can result in kidney failure.

When Is a Heart Attack Not a Heart Attack?

Carnitine palmitoyltransferase II deficiency