Sudden Cardiac Arrest in Young Athletes

By Hope Howard, Hannah Rodriguez, Kat Jennings and Yixuan Wang

CONCORDIA-- For the first time at Concordia High School, students have the opportunity to identify potentially life threatening heart abnormalities.

Most Missouri schools don’t require or offer pre-participation heart screenings for their student athletes. The effectiveness and validity of electrocardiogram, or EKG,  testing is debated in mid-Missouri and throughout the country even though it can detect an abnormality that can cause fatal sudden cardiac arrest.

On Saturday, Concordia R-2 School District is teaming up with Wimbledon Health Partners to provide heart screenings to interested students. Wimbledon is a company based in Florida providing on-site cardiovascular diagnostic testing for high school, college and university athletic programs throughout the country. Many of these students and athletes may have otherwise never been screened due to the high costs of this preventative measure.

The condition is described as “an abnormality in the heart’s electrical system when the heart suddenly and unexpectedly stops beating effectively,” according to Sudden Cardiac Arrest Foundation. This is different from a heart attack as during SCA the heart actually stops beating and victims lose consciousness.  Nine out of 10 SCA victims die as CPR and defibrillators must be administered immediately within at most 5 minutes of affliction according to the SCA foundation.

Laura Aronson, from Lee’s Summit, is the mother of Emma Aronson who died from SCA in June of 2015. Emma was a student athlete playing basketball at Lee’s Summit High School. Aronson passionately feels all students should be screened before participating in school sports.

“I mean it’s absolutely the most devastating thing that a family can go through, and it just affects your whole entire life,” Aronson said. “Even if we just save one. All the effort is worth it.”

As of yet, there are no national mandates requiring preparticipation EKG screenings for college or high school athletics. Yet, on average, one student athlete dies every three days from SCA, according to a study by Dr. Jonathan Drezner, the director for The Center of Sports Cardiology at the University of Washington in Seattle.

Dr. Greg Flaker, a cardiologist at University Hospital in Columbia, Missouri says heart screenings do not always catch irregularities. Since on average they are estimated to cost around $40 per student, there is controversy about whether or not heart screenings should be mandated in schools.

The American Heart Association agrees “that the mandatory screening of all young athletes with an EKG is not warranted based on cost due to the large number of tests that would be required,” according to the US National Library of Medicine.

However, in 2016 the NCAA set certain guidelines for preventing SCA by utilizing screenings. Drezner was on the NCAA committee helping to set the guidelines.

“Should all high school athletes get an EKG is a complicated question and the answer is not easy. You know some places are doing it, so should everyone be doing it?” Drezner said.  “That’s not what I would suggest either. Even if you really want to do it, and you think it is justified you still probably shouldn’t do it because it may create more problems than good.”

Drezner says usable and effective EKG screenings depend on someone who is knowledgeable about how to operate testing. According to Drezner, interpreting results with accuracy is also just as important since a misreading can be harmful to patients.

Still, opinions widely vary on the extent of EKG mandates. The specific requirements for sports physicals are established by the sports medicine advisory committee through the Missouri State High School Activities Association. The association sets sports mandates for around 580 schools within the state including Concordia Schools.

Its communications director, Jason West, does not think a “blanket policy” mandating cardiovascular testing is particularly appropriate at the high school level.

“That being said there is an understanding that every time you get on the field or on the court there is a risk for something to happen and you kind of balance that as you go along,” West said.

Mandating heart screenings for student athletes remains a controversial and highly debated topic as the effectiveness of testing continues to be evaluated. Concorida remains but one school taking a side on the issue.

“I think the change in rules and how techniques are taught in the various game has kind of shown that student safety and risk minimization is paramount in just about everything there is,” West said.