Athletic participation has doubled in the last 10 years. There are 7.7 million high school athletes and 450,000 college athletes. Pre-participation evaluation has been a hot topic in the U.S. in an effort to decrease and detect athletes who are at risk for sudden cardiac death. Pediatric Cardiologist Alex Arevalo, MD, explains screening guidelines and when athletes need to see a cardiologist.

The American Heart Association has developed a 12-point screening guidelines. I think this is a good start to screen our athletes.

The guidelines look at the family history of heart disease:

  • Is there a family history of somebody dying suddenly younger than the age of 30 year without a known cause or believed to be cardiac?
  • Are there heart conditions in family members younger than the age of 50 years?

The guidelines also look at personal history:

  • Is the athlete experiencing unexplained tiredness (fatigue) on the field?
  • Does he/she have high blood pressure (hypertension)?
  • Does he/she have a history of abnormal heart exam by a physician (murmurs)?
  • Does the athlete experience chest discomfort, passing out (syncope) or heart racing (palpitations)?

My goal as a cardiologist is always to maximize people's athletic potential. It does not matter if you have had open heart surgery six months ago or if you are as healthy as a horse. You need to be exercising. The more appropriate question is how much and how hard.

At the Le Bonheur Heart Institute, we have many diagnostic tools to evaluate our athletes including exercise stress testing, cardiopulmonary stress test, stress echocardiography, cardiac MRI and state-of-the-art CT scanner. We have physicians who want to take care of the athlete in us. We have taken a proactive approach in trying to help people who want to have a healthy lifestyle.

When should athletes see a cardiologist?

1. When you are having symptoms during exercise that are concerning – including chest pain, palpitations and syncope/passing out.

2. If the athlete has other medical problems that may or may not involve the heart and they want to perform competitive exercise. We currently have more adults that are survivors of congenital heart conditions than there are children who were born with heart conditions. Also, survivors of childhood cancers, cystic fibrosis patients and kidney problems should be evaluated.

These athletes take a higher level of testing and evaluation to make sure they are safe in the sports arena.

Learn more about sports cardiology at Le Bonheur.