Physicians are not Doing All They Can Do to Screen for Sudden Cardiac Death in Sports Physicals says Dr. Paul Pisarik at Owasso Family Medicine

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Only 6% of the physicians surveyed did everything recommended to screen for sudden cardiac death in high school athlete sports physicals says a researcher at an American Heart Association meeting.

There are stories in the paper of seemingly healthy boys or girls who die suddenly of an undetected heart problem while playing sports. One of the purposes of a sports physical is to screen for potential heart problems in the athlete. The American Heart Association (AHA) has recently updated its guidelines on trying to detect these hidden problems. Unfortunately, in a recent meeting of the AHA, a study was presented that showed most physicians (94%) doing sports physicals, do not do all they can do to screen for sudden cardiac death ( They either they do not ask the right questions or do not do all of the recommended heart and blood vessel exams.

Part of the problem was that only half of the physicians knew the latest guidelines from the AHA. Another part of the problem is that the forms the schools have are not up-to-date with the latest recommendations from the AHA. See for a sample of what an up-to-date sports physical exam form looks like.

Some of the recommendations from the AHA include asking about:

    Chest pain with exercise
    Fainting during or after exercise
    Feeling more short of breath than expected during exercise
    Fatigue associated with exercise
    Having a history of a heart murmur
    Having a history of elevated blood pressure
    Having a family history of sudden death before the age of 50
    Having specific heart conditions in family members that can be inherited by the athlete being examined.

It is critical that both the parent and child fill the form out together since the parent would not necessarily know if their child had chest pain with exercise and the child would not know that an uncle died suddenly at age 35 of long QT syndrome.

For the heart-related portion of the physical, the AHA recommends:

    Listening to the heart for murmurs in both lying and standing positions
    Checking a blood pressure
    Checking for Marfan’s syndrome
    Checking a femoral (groin) pulse at the same time as a radial (wrist) pulse.

If a sports physical is done properly 3% to 14% will have some finding(s) that that will need further evaluation (Preparticipation Physical Evaluation, 4th edition, 2010, page 2). A high blood pressure reading is one that is surprisingly common – up to 6% of children can have this (Pre-Participation Physical Evaluation, 4th Edition, 2010, page 47) – and it is commonly missed. There is no guarantee that even if everything on the new AHA guidelines checks out, that a child couldn’t still have a serious heart-related issue, but the AHA guidelines are the most up-to-date screening that is available.

Owasso Family Medicine does sports physicals as recommended by the AHA for $25. Call 918-212-6332 for an appointment or visit .

Owasso Family Medicine – Conscientious, Complete, and Caring.

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