ALAMEDA; EKGs might save lives among young athletes; Cause of teen's death on Alameda soccer field not yet known.(BAY AREA)
Periodical
Byline: Kavita Mishra, Ilene Lelchuk
In Italy, extensive medical testing of both youth and professional athletes has nearly eliminated cases of sudden death during competition, reducing the number by 90 percent since mandatory screening began in 1982.
In the United States, the same kind of advanced testing, involving an electrocardiogram and a heart ultrasound, is required of all pro athletes, but not for youths who play sports.
What is expected of young athletes before they take the field varies. Public schools in California and Pop Warner football leagues, for instance, require simple physical
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Rigorous advanced medical testing may or may not have prevented the death Saturday of a 16-year-old Alameda student during an indoor soccer game with Bladium Sports and Fitness Club, a private organization. By late Monday, the Alameda County coroner had not determined why Ifeanyi Ezeh died. The cause of death may not be known for weeks.
Experts say the most common reason for cases of sudden death in athletes in the United States is a pre-existing heart problem or trauma to the chest from forceful contact, like a head-butt or ball, both of which can cause an arrhythmia, or abnormal beating pattern of the heart.
Sudden death in young athletes is extremely rare -- resulting in only 300 deaths a year out of an estimated 10 million to 15 million participants in organized sports nationwide -- but the most likely culprit, a genetic defect that can cause the heart to fail without notice, can be found in 1 person out of every 500. One in 250 Italians has a similar heart condition that causes most cases of sudden death in young people there.
More than half of the cases of athletes who die while playing in the United States is caused by hypertrophic cardiomyopathy, a disease caused by abnormal muscle cells in the heart, said Dr. Michael Crawford, a UCSF cardiologist and member of the American Heart Association's Council on Clinical Cardiology.
In Italy, any athlete found to have a heart problem after testing is not allowed to play, a 1982 policy that resulted in a decline in the number of athletes who died during competition, said Dr. David Cannom, a cardiologist at Good Samaritan Hospital in Los Angeles and an expert in electrical physiology.
In the United States, however, the American Heart Association opposed a proposal earlier this year to recommend electrocardiograms, said Crawford, who was on the committee that made the decision.
"We don't have enough of a health care industry to do (EKGs) for the millions of kids doing sports," Crawford said.
And, Crawford said, the group concluded the cost would be too high to require an EKG for all athletes. An EKG costs about $50. If it detects