Should teen athletes get an EKG?

For parents of teenagers who play sports, concerns about heart health are common — and an electrocardiogram (ECG or EKG) can seem like a reassuring tool.

This simple, painless test checks for heart rhythm problems or other cardiac issues that could put young athletes at risk.

But is it necessary for every teen athlete?

While some schools and sports leagues offer free or reduced-cost EKG screenings, and some families may choose to pay for them independently, leading organizations don’t recommend universal EKG screening for all athletes at this time.

That’s because, for most healthy young people without risk factors, the costs may outweigh the benefits.

As a pediatric cardiologist at the University of Chicago Medicine, I often talk with families who wonder if their child should get an EKG. Here’s what parents need to know:

What does an EKG detect?

An EKG uses sensors placed on the skin to measure the heart’s electrical activity — specifically, the signals that tell the heart muscle when to contract. This information helps doctors assess the heart’s rhythm and some other factors.

An EKG can help detect:

• Hypertrophic cardiomyopathy: Thickening of the heart muscle that can make it harder for the heart to pump blood ­— a top cause of sudden cardiac events in young athletes.
  
  
• Dilated cardiomyopathy: Weakening or stretching of the heart muscle, which reduces the heart’s ability to pump blood effectively.
  
  
• Long QT syndrome: An inherited condition that affects the heart’s electrical system and can cause dangerous, potentially life-threatening irregular heartbeats (arrhythmias).
  
  
• Wolff-Parkinson-White syndrome: An extra electrical pathway in the heart that can cause episodes of rapid heartbeat (tachycardia).

These issues are rare, but they are important to catch because they can increase the risk of sudden cardiac arrest during intense physical activity.

What should student athletes do instead of an EKG?

The American Heart Association and American College of Cardiology recommend that all student athletes undergo the AHA’s 14-point pre-participation screening.

This includes a check of the athlete’s personal and family medical history and a physical examination. The screening can be done by your family doctor or pediatrician.

If there are any concerns — such as a heart murmur, fainting episodes during exercise or a family history of sudden cardiac death — the doctor may recommend an EKG.

They also may refer the athlete to a cardiologist for additional tests, such as an echocardiogram (ultrasound of the heart) or a stress test (monitoring the heart during exercise), depending on the clinical scenario.

Families should always take warning signs seriously. If a teen experiences chest pain, fainting during activity or anything unusual while exercising, they should see a doctor right away.

Why an emergency plan matters for student athletes

Whether or not an EKG screening is conducted, it’s crucial for schools and teams to be prepared for rare emergencies.

Every athletic program should have staff trained in CPR, an accessible automated external defibrillator (AED) and a clear plan for responding to cardiac events

Prompt action saves lives: Starting chest compressions and obtaining an AED immediately can make a huge difference if someone goes into cardiac arrest.

To help keep young athletes safe and give parents peace of mind, follow this game plan:

• Schedule a thorough physical exam
• Know your family’s medical history
• Watch for warning signs and seek care immediately
• Have an emergency plan in place at every practice or game