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Hot Topic (8/28): Should kids' hearts be tested before playing sports?

Posted by on Aug. 28, 2009 at 2:24 AM
  • 14 Replies

 

ST. LOUIS â€”  ST. LOUIS (AP) — An obese eighth-grader's sudden death during a football conditioning lap has revived discussion about whether testing children's hearts before they engage in sports or strenuous activity is necessary.

Anthony Troupe Jr. collapsed last week on a suburban St. Louis football field before he finished running a lap before practice. The oversized 13-year-old was pronounced dead at a local hospital an hour later.

The boy, known as "Big Ant" for his 6-foot-2-inch, 383-pound body, had a good work ethic and moved as fast and strong as boys less than half his size, coach Lonnie Jordan said.

"He knew he was a big guy, and knew what his job was as offensive guard, and defensive tackle," Jordan said. "He was proud of it."

An autopsy was performed but cause of death won't be available for several weeks pending tissue and toxicological test results, said Dr. Mary Case, St. Louis County medical examiner, adding that the boy's weight and heart are "certainly a consideration."

And, perhaps too, family history.

The boy's father, Anthony James Troupe Sr., collapsed and died at age 45 after working a night shift in April 2007. "He clocked out, and he clocked out," said Anthony's mother, Carol Howard. His death certificate states what roughly translates to high blood pressure and clogged arteries.

Dr. Keith Mankowitz, a professor of medicine at Washington University who specializes in prevention of sudden death in athletes, said 13-year-old boys don't die of morbid obesity.

"He had to have had some underlying heart problem," said Mankowitz, who suspects Anthony and his father had hypertrophic cardiomyopathy, the most common genetic heart condition that thickens the heart walls. It's also the most common cause of sudden death in athletes.

The condition may go undetected in routine screening, and would need to be confirmed by a heart specialist referred by a practitioner who grew suspicious of symptoms, a murmur or family history of sudden death, said Mankowitz, who directs an athletes screening program at Washington University.

He believes that every kid who want to play sports should get a good history and physical exam, and that if either uncovers a red flag, the student should be examined by a cardiologist, and receive periodic follow-ups. He said those are American Heart Association recommendations.

Dr. Cam Patterson, cardiology chief at the University of North Carolina, Chapel Hill, agreed that father and son may have shared the heart defect.

In Italy, a national screening program is credited with lowering the incidence of sudden cardiac death among young athletes, he said.

In the U.S., screening is the subject of debate, which centers around cost and the concern over an able athlete being held back because of non-definitive test results, Patterson said. He believes anyone who wants to engage in competitive athletics should have an EKG to detect problems resulting in sudden cardiac death in athletes.

"But do you do an EKG on 5 million kids to find 15 cases?" asks Dr. Robert Eckel, past president of the American Heart Association and professor of medicine at University of Colorado Denver Medical School. "It's a matter of cost and benefit."

On the other hand, he said, "If you're a parent who has lost a child, an EKG should have been done."

Eckel, an endocrinologist with a specialty in preventing heart disease, said that Anthony's extreme size suggests another possible problem such as a tumor producing too much growth hormone.

Most states require students to get physicals before participating in sports, "but will that catch everything? Probably not," said Bruce Whitehead, executive director of the National Interscholastic Athletic Administrators Association of middle- and high school athletic directors.

The physicals do not include EKGs that would detect subtle heart defects, but that shouldn't stop parents from getting extra tests when there is family history of heart problems, he said.

"There are 7 million student athletes across the U.S. annually, and that's just high school," he said. "It gets to be a matter of, do you test 7 million or isolate some students based on family history?"

Dr. John Galgani, who specializes in pediatric endocrinology, was the boy's pediatrician. He declined to discuss his case, citing confidentiality and an unwillingness to add to the family's pain.

"It's unimaginable to have this happen to your child," he said. "It's such a horrible thing to happen."

* * *

Should everyone who wants to engage in competitive athletics have an EKG to detect problems resulting in sudden cardiac death in athletes?

What do you think?  Is the cost of such testing worth it?

 





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by on Aug. 28, 2009 at 2:24 AM
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Replies (1-10):
Littles1921
by New Member on Aug. 28, 2009 at 2:29 AM

In my area, if you want to participate in school sports, you have to have a physical every year.  An EKG???  Maybe no..........   But a 13 year old at 6'2" and over 300 pounds??  He should have been under a Dr.'s care WAY before he ever stepped on the field!!  (Just my opinion!!)  :)

mamaof2angles
by on Aug. 28, 2009 at 2:51 AM

I agree witht he last part, in my state you CANNOT even step foot on the field with out a physcial, and yes I think kids hearts should be tested, we have had many childern here die for undigonosed heart issues. JMO

Quoting Littles1921:

In my area, if you want to participate in school sports, you have to have a physical every year.  An EKG???  Maybe no..........   But a 13 year old at 6'2" and over 300 pounds??  He should have been under a Dr.'s care WAY before he ever stepped on the field!!  (Just my opinion!!)  :)


hsteele
by on Aug. 28, 2009 at 4:14 AM

I think parents should be made aware of the risks especially parents of severely obese children or in families where there is a history of heart disease, but how many parents have a hard time affording the physical, much less an EKG. For parents with med insurance this is easier, but what about families without? A mandatory EKG coild prevent a lot of healthy but poor kids from being able to participate.

Heather
Proud Pagan Momma

"If Evil exists its a pair of train tracks,
And the Devil is a railroad car."

Josh Ritter "Harrisburg"

mamaof2angles
by on Aug. 28, 2009 at 5:14 AM

Agree on the cost of EKG but physicals do not cost that much and most city/county health departments will do them for like $10 if even that, but since a coach is being charged with the death of player from last augest in KY what are we supposed to think??? I saw a comment from someone in TN that said "Coachs only care about winning and not the kids!'  That could not be farther from the truth, come to a Captail High Football practic or hang out with the students during condationing, that could not be father from the truth.

Quoting hsteele:

I think parents should be made aware of the risks especially parents of severely obese children or in families where there is a history of heart disease, but how many parents have a hard time affording the physical, much less an EKG. For parents with med insurance this is easier, but what about families without? A mandatory EKG coild prevent a lot of healthy but poor kids from being able to participate.


EireLass
by Ruby Member on Aug. 28, 2009 at 8:21 AM

In my area, the kids have to have complete physicals prior to starting a sport. And we would assume by this time they've had years of medical attention through basic care. If the kids is in 6th grade and 380#, didn't anyone notice anything out of place? His parents? His physician? The COACH! 

MomIWant
by Member on Aug. 28, 2009 at 11:03 AM

Yes, Yes, Yes & Yes - IMO all student athletes should have an EKG prior to playing.   During football season, almost every year, you hear of a student having a heart condition during practice.  Even those in very good condition can have an undetected problem - if an EKG can save one life - it is well worth the risk.  In most areas, you now have to pay to play, adding the cost of an EKG I think is worth your child's life!

stormcris
by Christy on Aug. 28, 2009 at 6:02 PM

I agree

Quoting MomIWant:

Yes, Yes, Yes & Yes - IMO all student athletes should have an EKG prior to playing.   During football season, almost every year, you hear of a student having a heart condition during practice.  Even those in very good condition can have an undetected problem - if an EKG can save one life - it is well worth the risk.  In most areas, you now have to pay to play, adding the cost of an EKG I think is worth your child's life!


PurdueMom
by Sherri on Aug. 28, 2009 at 11:08 PM

Speaking as a cardiac nurse: no, I don't think all athletes should be required to have an ECG.  I DO think it prudent of parents to get an ECG of their child if he or she has a medical history of heart problems or a strong family history of heart problems.

An earlier poster mentioned the case in Kentucky.  A prior ECG would not have saved that poor, young man's life.  A glass of water would have.

Sherri
PestPatti
by on Aug. 29, 2009 at 1:08 PM

 

 When I took CPR,  I took a providers course through my employment, said that children do not just have cardiac arrest.  There is an underlying cause, and they are usually born with it. 

Routine test done by a PCP during a physical iare not necessairly going to catch that.  Most find out they have the issue, after the fact.     

happychick2525
by on Aug. 30, 2009 at 2:06 AM

I often times wonder if black people should get tested for sickle Cell as well, it's risky for a kid to be out there with any form of sickle cell which can probably be aggrivated when being so active.  Just a thought!

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