Should an ECG Screening Be Part of Your Child’s Sports Physical?

An electrocardiogram (ECG) is a powerful tool for detecting heart defects, so some consider it an important part of a child’s physical exam when participating in sports. Although rare, sudden cardiac death in young athletes is often widely talked about when it does occur.

Some doctors and medical researchers feel that ECG screenings at a pediatric heart center in school-age athletes may be necessary to reduce the risk of sudden cardiac death. However, others feel that diagnostic tests used to screen for cardiovascular abnormalities is ineffective.

Some Doctors Say Yes

In a discussion held at the American College of Cardiology Scientific Session, Francisco Fedele, MD, argued that cardiologists in Italy see an ECG as a mandatory part of a young athlete’s physical exam. Sudden cardiac death tends to affect athletes undergoing puberty more than younger children.

He said while an ECG screening is more helpful in teenagers and older children, it is still an effective supplement to a physical exam and examination of a family’s cardiac history. Simply receiving an ECG at a pediatric heart center as part of a physical can spur family discussions that lead to important insights.

Although it isn’t a required part of an athlete’s physical in the United States, some countries such as Canada, Italy, Japan and Israel have made ECG screenings mandatory.

Other Doctors Say No

Other doctors say that mandatory ECG screenings for young athletes aren’t necessary, and may do more harm than good. Critics point to questions about the appropriate age to begin testing and the possibility for false positives.

Because of the way heart defects can develop, a condition may not be noticeable in a screening until a person reaches young adulthood. Because of this, kids who are screened at a younger age may go unnoticed in later years and be at a heightened risk for sudden cardiac death later.