Sports Preparticipation Exam an Important Part of Back-to-School Time for Student Athletes Aug. 25, 2000 -- Amid the chaos of starting a new school year, fitting in a medical exam so your child can play a sport might seem like just one task too many. After all, these are young, robust, and healthy athletes, right? Mostly. But, consider this statistic: Sudden cardiac death strikes about 1 in every 200,000 high school athletes each year. Knowing what this exam should include could save your young athlete's life.

While nearly 8 million high school and college students participate in sports each year and the incidence of sudden cardiac death is rare, it does happen. This is why the American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American College of Cardiology (AAC), American Heart Association (AHA), and several other national health organizations and societies have recommended cardiovascular screening as part of the comprehensive sport preparticipation physical evaluation (PPE) that high school and college athletes should have before being allowed to participate in an athletic program.

Their recommendations, published in the Aug. 15 issue of American Family Physician, define sudden cardiac death as "a nontraumatic, nonviolent, unexpected event resulting from sudden cardiac arrest within six hours of a previously witnessed state of normal health.

"Currently, there is no cost-effective battery of tests to identify all -- or even most -- of the dangerous cardiovascular conditions," the authors write. However, the AHA and other organizations recommend certain criteria be met for a good screening physical.

"In screening of children who may be participating in sports, physicians are able in many instances to detect potential underlying cardiac conditions that may put a child at risk," Janette Strasburger, MD, tells WebMD. "The most common would be cardiac malformations that result in heart murmurs ... or the presence of hypertrophic cardiomyopathy." Hypertrophic cardiomyopathy is an abnormal thickening of the heart muscle that accounts for about 36% of sudden cardiac death in young athletes.

Unfortunately, not every potentially deadly heart condition can be detected during a physical exam alone. This is where personal and family history comes in.

"Many times, family and personal history can be helpful in identifying familial types of disease that may place a young person at risk even though they are not having symptoms," says Strasburger, who is director of the Dr. Scholl Cardiac Exercise Lab at Children's Memorial Hospital in Chicago. "The presence of an unexpected sudden death, especially of a young family member, and the presence of known disease states are important."