Every parent knows that if their child wants to participate in organized sports, a preparticipation exam is required. The athlete must see a physician, have a form filled out, and turn the form in. While it may seem like we are jumping through hoops, the medical doctor must take this exercise very seriously.
Every year, there are reports of athletes suffering fatal heart or other life-threatening conditions on the field. Hypertrophic cardiomyopathy, (HCM or HOCM) is the most famous as a leading cause of sudden cardiac death in young athletes. Hypertrophic cardiomyopathy is a disease of the myocardium (heart muscle). Part of the myocardium becomes hypertrophied (thickened) without any obvious cause.
Various medical societies recommend an exam every two years for younger athletes, and every two-to-three years in older athletes. Specific ages have not been standardized as yet. A thorough exam is advised at the start of new phases (e.g., upon entering middle school, at the start of high school, when participating in sports for the first time).
A modified and less thorough update exam can be performed each year in-between major transition periods. Any important health changes can be noted at that time. This might include changes in height and weight, any new personal/family history of injury or illness, and current blood pressure.
Many schools require the preparticipation exam every year for liability reasons. There isn’t any real data collected to show that this is necessary. Studies are needed to confirm that performing an annual exam actually reduces the risk of injury or death in student athletes.
There’s still some debate about the need for special tests such as electrocardiograms (EKGs). Studies from Europe support the need for all competitive athletes to have routine EKGs. They report 90 per cent fewer deaths from cardiovascular causes.
But the American Heart Association says that a normal EKG doesn’t mean the athlete won’t have a significant heart-related event. These tests just aren’t sensitive enough to detect all abnormalities and they are expensive to conduct on everyone involved. One false-positive test leads to more tests that may be unnecessary. At the present time, there are too few athletes for whom this type of testing is really needed. There’s no need to subject everyone to the test for the sake of a very few who might be affected.