Should All Student Athletes have a Routine Screening 12 – Lead EKG Annually.
The American Heart Association (AHA) and American Academy of Pediatrics (AAP) once again have reviewed the world literature on beast practice for screening student athlete’s starting in freshman year of High School, to rule out the most life threatening and most common cardiac conditions that are responsible for unexplained Sudden Cardiac Death (SCD) in young athletes. While these cardiac conditions remain rare, larger population screening programs across the US and globally are identifying more and more of these conditions, raising important questions about what kind of screening and how often our children should be screened.
Children’s Cardiovascular Medicine has summarized the most important take away points form the AHA/AAP guidelines published in July 2021 with the intention of facilitating primary care and parental decision making during this season when many are seeking sports physicals.
Primary takeaway points from the AAP/AHA policy statement:
- ALL pediatric patients seeking sports clearance should be evaluated for the most common pediatric cardiac conditions predisposing them to Sudden Cardiac Arrest (SCA) or Sudden Cardiac Death (SCD) in the course of routine healthcare utilizing evidence-based sports participation instruments and having a practice protocol for immediate referral to Children’s Cardiovascular Medicine (404-943-0289 referral #)
- ALL pediatric patients seeking sports clearance should have a thorough, office-based personal and family medical history and complete physical exam as a starting point necessary for ruling out SCA and/or SCD risk.
- ALL pediatric patients seeking sports clearance in whom a suspicion of SCA/SCD is documented, should have as an initial cardiac screen, a 12- Lead EKG read by the Board-Certified Pediatric Cardiologist at Children’s Cardiovascular Medicine (404-943-9787 Fax #). CCM offers ‘same day EKG only visits and interpretations 365 days annually. (**CCM has partnered with the innovative SmartheartPro Bluetooth EKG providers to provide you with a machine for your office ‘free of charge’ provided it is interpreted by CCM. Call Dr. Montaña @ 404-213-6060 to inquire and for a demonstration)
- The AAP/AHA guidelines state further that ALL pediatric patients seeking sports clearance in whom an EKG is being considered, the pediatrician should not perform the EKG in ‘isolation” and without full History and Physical as advised, and referral to a Board-Certified Pediatric Cardiologist at Children’s Cardiovascular Medicine should be strongly considered if you suspect increased risk of SCA/ SCD. (404-943-0289 referral #)
- ALL clinics evaluating pediatric patients seeking sports clearance should not rely solely on the EKG machine interpretation which is often incorrect and not programmed to pediatric standards.
- ALL clinics evaluating pediatric patients seeking sports clearance should implement an emergency action plan and train staff on basic CPR and PALS and location of the clinic AED which should be maintained to quality standard.
- Lastly, The AAP/AHA guidelines in Figure 1. Displays these recommendations in a visual format for those of us more inclined.