Unlike many on Crickles I am a long way from being a professional athlete. I ran the London Marathon in 2001 and was overtaken by a tree. At last year’s Porlock Hill Climb (which I went to, but failed to enter in time) I would not have been last. But 31 minutes is not great. Most of my sporting activity is to help my kids. My youngest likes to run – typically about 10K. My middle one loves cycling and triathlons. As they are young (11&13) I do most of their training with them. It’s getting harder, and I can see a time in the not too distant future when I won’t be able to keep up.

My day job involves many things, but I specialise in sudden cardiac death. All too often I am dealing with families who have lost someone out of the blue. Sometimes they are athletes, probably more often than chance would predict, sometimes not.

Around 1 in 50,000 athletes <35 years old die suddenly each year.

So I wonder about whether or not I should get my kids screened. Many conditions which lead to sudden cardiac death can be picked up by quite simple tests, such as electrocardiograms (ECGs). It takes 5 minutes. In countries such as Italy and France there are widespread screening programmes. I sometimes see people from the UK who have abnormalities picked up when they have  been to Europe to participate in an event, and had their mandatory ECG.

There has been a limited study in the UK, run by Sanjay Sharma, probably the best known Sports Cardiologist in the UK. They screened almost 5000 athletes between 14-35. 1 in 300 had a potentially serious underlying conditions after more complete evaluation. ECG screening seems to work. A large study in Italy demonstrated that it reduced the risk of sudden death in athletes by 90%.

But it’s not quite so easy. Athlete’s ECGs are “abnormal” anyway, and knowing what is normal for an athlete takes training. Furthermore, many people with abnormal ECGs don’t have problems after more detailed testing.

As some will know, identifying something potentially serious doesn’t mean that something serious will happen. In fact for some diagnoses, such as long QT syndrome, it is often more likely that nothing serious will happen. And then they may be banned from sporting participation, and struggle to enter certain careers. A diagnosis, which may never cause harm, can be life changing. I have all too often been unable to help families, who want to know what the future holds. I see people desperately grasping for certainty where none exists.

On the basis that I haven’t dropped dead yet, and neither has my wife, and on the basis that my kids are still amateur and have no symptoms, I think I’ll leave it a bit longer. But as data mounts, and if they become more serious, I will probably err towards organising some testing for them. Like most parents, I worry far more about them than I do myself. In the meantime I’ll be cycling with one son on Sunday on Exmoor.

If you are more interested, try starting here:

https://bjcardio.co.uk/2017/01/cardiovascular-screening-of-young-athletes-with-electrocardiography-in-the-uk-at-what-cost/

Written by mjd

A 40something cardiologist from the UK

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