Screening athletes for SCD.

The American Heart Association has issued the nation's first set of standardized recommendations for the screening of young athletes for potentially fatal cardiovascular disease. The guidelines were created by a panel of leading cardiovascular and sports medicine specialists.

Sudden death in competitive athletes is rare, indicates Barry Maron, director of cardiovascular research, Minneapolis Heart Institute Foundation, estimating that about one in 200,000 high school athletes dies while on the practice or playing field or arena. When such catastrophes do occur, the athletes' parents, school administrators, parents of other athletes, and the media naturally question, "How could this have happened?," raising the issue of whether the death could have been prevented by medical evaluation.

Totally eliminating sudden cardiac deaths among high school and college competitive athletes is a practical impossibility, Maron emphasizes. "There is no way that all potentially fatal heart conditions can be detected through pre-participation screening. The public must realize this [as well as] that, to a certain extent, participating in competitive sports is part of the risk of living."

The recommendations include:

* Making pre-participation cardiovascular screening -- including a physical examination and a complete and careful personal and family history -- mandatory for all athletes. Clues to potentially fatal inherited disorders that may not show up in a routine physical exam sometimes can be detected by taking a detailed medical history of both the athlete and his or her immediate family. These may pinpoint danger signals that a physical exam couldn't be expected to find.

* Conducting this screening prior to the athlete's initial engagement in high school or collegiate sports and repeating it every two years.

* Requiring all athletic screening to be performed by a licensed physician or another appropriately trained health-care worker with the medical skills and background necessary to recognize the signs of heart disease.

* Listening to hearts of athletes while they are standing and lying down to identify heart murmurs and other problems.

* Including blood pressure...