Debate Over Heart Screenings Refuses to go Away
By Solange Reyner
Associated Press Posted: 05/30/2009 08:11:36 PM EDT
Her softball team had just won, and Claire Dunlap was kneeling with her teammates for a postgame chat when her heart stopped beating.
As shocked teammates and fans looked on, a trainer and an off-duty paramedic used a defibrillator to shock her heart and save her life. Not all young athletes with undiagnosed heart problems are so lucky.
"I was calling my husband to tell him that we had won," said Patti Dunlap, Claire's mother. "I remember looking out on the field, and hearing my name being screamed to come out so I dropped everything and ran out to see what was happening."
Dunlap, a sophomore at American Heritage High in Delray Beach, Fla., had suffered sudden cardiac arrest caused by an abnormal heartbeat.
Her doctors still don't know what caused the irregular heart beat, but believe the condition is genetic and could have been detected by an EKG. She hasn't resumed playing softball yet but is expected to in a month or so.
Dr. Barry J. Maron, director of the Minneapolis Heart Institute Foundation, estimates that 125 athletes ranging from age 8 to 39 die from sudden cardiac arrest in the U.S. each year.
The debate over whether more intensive screening of athletes could prevent some of these deaths tends to pick up steam after a high-profile case. A recent example is Ryan Shay, the marathoner who died of an irregular heartbeat due to an enlarged heart after collapsing during the U.S. men's Olympic trials in November 2007.
Many groups, including the American Heart Association, say the number of sudden cardiac deaths in athletes is low and more extensive screening isn't practical or cost-effective.
Other experts say most deaths could be prevented by giving athletes who compete in organized sports either an electrocardiogram (EKG), which measures the heart's electrical activity, or the more thorough -- and more expensive -- echocardiogram, an ultrasound scan of the heart.
"As health care personnel, we struggle with why we have not done a better job to prevent more of these deaths," said Dr. Craig Asher, a cardiologist at the Cleveland Clinic in Weston, Fla. "You can quibble whether it's 100 or 200 or 300 that die, but if it's preventable with a relatively low-cost test, why not?"
Prices for the tests vary, but Asher says an EKG costs about $100, while an echocardiogram provides a more thorough and accurate screening for around $1,200.
Yet Maron says to mandate such testing wouldn't be cost-effective for the nearly 8 million high school and college athletes competing in the United States. "It's very tragic every time it happens, but in numerical terms, it's a low-rate phenomenon," he said.