Cardiologist encourages screening student athletes for heart problems

Nearly one month after a Newport Beach student athlete’s heart stopped, a pediatric cardiologist recommended cardiac screening beyond what the American Heart Assn. advises and the school district requires.

Addressing a few dozen parents at a Corona del Mar High School PTA meeting Wednesday, Dr. Uthara Mohan, who practices in Newport Beach, said a physical examination by a doctor — required by the Newport-Mesa Unified School District before a student’s participation in sports — cannot detect all underlying heart conditions.

The district’s examination form does not specify cardiac screening. The document does, however, include heart-related questions, such as: Have you ever been told you have a heart murmur?

“Really, the parents are the ones who have to be the advocates here,” Mohan said.

Questions about cardiac screening surfaced last month when Safvet Besen, a junior at the school, was hospitalized after his heart stopped. A varsity soccer player, Besen collapsed at his home Feb. 7 shortly after soccer practice.

Doctors later discovered that Safvet has a heart arrhythmia called long QT syndrome, his mother, Heather Besen, told the Daily Pilot last month. The teen’s heart was found to be working at only 40% of normal capacity. Surgeons implanted a defibrillator in the 16-year-old last month.

On Wednesday, Mohan talked about athletes who have collapsed on the field because of undiagnosed, underlying heart conditions and described some early warning signs that parents should be mindful of, such as unexplained bouts of fainting.

European countries have backed greater adoption of routine cardiac screening than has this country, Mohan said.

Italian law requires athletes ages 12 and 35 to undergo an electrocardiogram, Mohan said. The International Olympic Committee also mandates the use of ECGs among its athletes, she said.

In this country, cardiac health screening follows guidelines set by the American Heart Assn., which does not include an ECG among its recommendations. The association cited a 12-year study of 1.4 million student athletes that reported one death per 200,000 high school-age athletes per year. Deaths occurred most commonly in basketball and football — high-intensity sports with high levels of participation, according to the association.

Mohan said that a study of cardiac tests found a 17% rate of false positives — essentially reporting a heart condition where one doesn’t exist. False-positive results can lead to the unnecessary exclusion of students from sports. Mohan also cited a study that found no change in the rate of sudden cardiac deaths between a group that underwent routine cardiac screening and one that did not.

Most insurance policies won’t cover cardiac screening unless the individual has a heart condition or is exhibiting worrisome signs that indicate a cardiac ailment, Mohan said.

Even so, she noted that parents spends hundreds of dollars annually on sports equipment. “Why not spend the money on your child’s heart?” she said.