Cardiac Screening Before Participating in Sports – Cleveland Clinic


As any parent knows, there is a long checklist of things a child must do before playing sports. Getting the right uniform and equipment is the first step. Then, take time out of your busy schedule to practice or play.

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Before that can happen, however, the student-athlete must have a physical. The results determine whether the child is allowed to play, and often a potential risk that requires further testing. Identifies health concerns.

Some student-athletes make annual pre-participation heart screening part of their routine, says pediatric cardiologist Akash Patel, M.D.

“The American Heart Association has created a pre-participation screening form,” says Dr. Patel. “This form identifies symptoms based on the child’s medical and family history and attempts to identify if the athlete has an underlying heart condition that puts them at risk. It adds to what you might stand on.”

Dr. Patel explains what cardiac screening includes, what age student-athletes should get it, and why it’s important.

Why should your child have cardiac screening?

Physicians use pre-participation cardiac screening to determine when a child “needs further evaluation before being cleared for sport,” says Dr. Patel. The job is to get candid responses and baseline heart health assessments in children.”

Pre-entry cardiac screening vs. physical examination

In addition to the sports physical examination, a heart screening is performed. Both tests are meant to measure your health, but the physical exam is more comprehensive and focuses on your whole self.

“With sports physicals, doctors want to make sure you’re healthy from head to toe,” explains Dr. Patel. “So it’s not just the heart, everything else is fine. in order to confirm the

Details covered in the health check include musculoskeletal issues your child may have, such as predisposition to ankle injuries. Doctors also ask about nutrition and mental health.

A history of concussions or head injuries, and whether you have headaches or cognitive problems, are also part of your body. Even a small impact can cause both a concussion or a head injury,” says Dr. Patel.

Contents of pre-participation cardiac screening test

Unlike sports-related physical examinations that focus on the athlete’s overall health, pre-participation cardiac screening focuses on heart health and heart condition. The screening is divided into her three elements:

personal educational background

Regarding personal history, preparticipation cardiac screening asks children about specific backgrounds such as:

  • Have you ever had any unusual symptoms during exercise? (eg chest pain, chest discomfort, palpitations or palpitations)
  • Have you ever felt dizzy or lightheaded?
  • Do you ever lose consciousness during sports activities?
  • Do you have high blood pressure?
  • Have you had an abnormal heart test in the past?
  • Have you had any abnormalities in your pre-participation cardiac screening?
  • Have you ever had a heart test that looked suspicious?

family history

During cardiac screening, doctors also check the child’s family history of heart problems. They may ask:

  • Do you have a family history of sudden cardiac death, especially if it occurred prematurely and/or as a result of activity? “This usually means under the age of 50,” says Dr. Patel. “I’m more concerned if you’re under 35.”
  • Do you have a family history of heart disease under age 50?
  • Do you have a family history of hereditary heart disease (long QT syndrome, etc.)?
  • Do you have a family history of hereditary cardiomyopathy (such as hypertrophic cardiomyopathy)?
  • Do you have a family history of connective tissue disorders like Marfan syndrome?

Physical examination

Pre-participation cardiac screening may also include a physical examination. In this case, doctors pay attention to such atypical signs as:

  • Heart murmur.
  • Hypertension.
  • Abnormal femoral vein in leg.
  • Features of syndromes associated with heart disease.

Cardiac Screening Warning Signs

The best-case scenario is that the doctor finds nothing of concern during the cardiac screening and the student-athlete is given the green light to compete. However, the screening warrants referral to a cardiologist for further evaluation. You may find something to do. Results that your doctor will flag for further testing include:

Signs of heart disease that put you at risk of sudden cardiac arrest

Dr. Patel says one of the things doctors are specifically trying to identify is a condition that can cause sudden cardiac arrest (also called sudden cardiac death). Sudden cardiac arrest is rare—estimates range from 1 in 50,000 to 1 in 300,000.

However, if a child lives with cardiomyopathy or a condition that affects the heart muscle, the risk of cardiac arrest increases during physical activity. In some conditions, the heart may harden, develop scar tissue, or become enlarged or thickened. Hypertrophic cardiomyopathy, in which the heart muscle thickens, is particularly dangerous, added Dr. Patel.

Symptoms during exercise

Powerful during all kinds of exercise, especially when you are doing sports. Heart problems may cause symptoms such as:

  • chest pain or discomfort“Children may experience musculoskeletal pain, shortness of breath, and chest discomfort when they are really exerting themselves.” If rest and hydration alone don’t help, it becomes a concern,” says Dr. Patel.
  • fainting/feeling faintFainting is “a big red flag,” warns Dr. Patel. “But even athletes who faint should be evaluated.”

He adds that context is important in terms of when they occur. For example, running in the heat of summer can lead to dehydration and heat stroke (rarely heat stroke), which can cause similar symptoms. “If these symptoms don’t go away with hydration and rest, and really don’t match your level of exercise, you should definitely get screened.”

fast heartbeat

Your heart rate naturally increases during exercise. “But if it feels like it’s beating too fast, or if your heart keeps beating very fast or irregularly even when you’re resting, it’s also a concern,” says Dr. Patel.

Tired easily and short of breath

Tiredness and shortness of breath can be a sign of heart disease or poor health, such as exercise-induced asthma.

But it could mean something more serious is going on. “It could be a sign or symptom that your heart isn’t working as well, or an abnormal heart,” says Dr. Patel. “If blood is hard to get out of the heart, it can cause symptoms like this.”

experience new symptoms

When considering fatigue and exercise-related symptoms, these signs may be red flags if they are new, have worsened over time, or are out of character with the athlete. You were the fastest kid on the team and now you’re taking a break every five minutes?” asks Dr. Patel. “Or are they asking coaches to pause and take a breather?”

What kind of athlete should undergo cardiac screening?

Doctors generally recommend heart screening for middle school and high school athletes. “On average, around age 12, he should start screening in sixth grade,” says Dr. Patel. “Some of these conditions do not occur at a young age.” In some cases, children under the age of 12 can also be evaluated. It generally occurs when symptoms appear.

Student-athletes should undergo these cardiac screenings annually. “People who do competitive sports should get a screen no matter how strenuous the sport is,” Dr. Patel advises. “If you’re doing competitive sports, I think it’s a must.”

As an example, he mentions tennis, which may not seem as intense. continue. “They might keep themselves in shape by running. And when they’re playing a tough game, it’s probably a more focused sport than saying you’re the kicker for a soccer team.

Even children who play recreational sports may benefit from cardiac screening. “Generally, we think about when a cardiac event occurs. It’s usually the typical top three for soccer, football, and basketball,” says Dr. Patel. “But the event can happen during any sport you can think of, from hockey to hockey to swimming, etc. It’s where your heart rate really goes up and you really push yourself and I sweat.

If a child suddenly develops new symptoms that may be signs of heart disease, parents should not wait until it is time for an annual check-up to be evaluated. However, new signs and symptoms should prompt appropriate follow-up by a primary care provider,” says Dr. Patel.

There are many positive things that happen in sports. Pre-participation cardiac screening can be done in tandem with a physical examination to provide reassurance to both students and parents.

“As competition increases, so does stress and the impact on mental health,” says Dr. Patel. “That’s why we see famous athletes take a break from sport. Evaluation has to be a holistic global process. We want to make sure that they are healthy from a mental and physical standpoint as well.”



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