How Much Caution Is Too Much?

Anthony Troupe, Jr., 13, collapsed in the third week of August on a St. Louis high school football field while running laps before football practice. Unfortunately, this story does not have a happy ending. Inspite of heroic CPR attempts, Anthony died of a sudden cardiac event related to a previously undiagnosed heart problem. He had passed his mandatory sports physical shortly before, but that physical did not include any sort of EKG heart testing. In Anthony’s case, there was a family history of heart disease evidenced by his father’s sudden death at the age of 45 after working a night shift in April, 2007.

Could Anthony’s life have been saved if a EKG test was a requirement prior to playing prep sports? There are an estimated 7 million high school athletes in the United States; should every one be tested for subtle heart defects that could potentially cause cardiac arrest during strenuous sports? In Italy, there is a national screening program that is credited with lowering the incidence of sudden cardiac death among young athletes. Can such a program be attempted in the much bigger United States with the same results? Should it?

Perhaps the answer does not lie in an all or nothing approach. Bruce Whitehead, the executive director of the National Interscholastic Athletic Administrators Association of middle and high school athletic directors, believes that such tests are indicated when a student athlete’s background indicates the presence of heart disease. This middle ground would no doubt catch undiagnosed heart conditions in a number of cases, but there will still be some victims with no known risk factors. Perhaps the parents of all student athletes should be given the information and the statistics and make their own informed decisions about whether to test or not. An unnecessary EKG would be far better than living with the pain of losing your child the way Anthony’s mother lost him.

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