"Study Adds to Debate over Heart Tests for Athletes"

ROBERT SIEGEL, host:

A study in The New England Journal of Medicine finds that a common heart test can identify some young athletes at risk of dropping dead from cardiac disease. But experts say it's not feasible to give it to everybody who wants to play sports.

NPR's Richard Knox reports.

RICHARD KNOX: Joanne Babbitt of Chatham, New Jersey has lived through the nightmare. Her 16-year-old son John was a strapping, three-season athlete.

Ms. JOANNE BABBITT (Chatham resident): One evening, he went down to play basketball in an intramural league that's part of his church youth group. And he was running down the court and he just collapsed, and died instantaneously.

KNOX: An autopsy showed that John Babbitt died from hypertrophic cardiomyopathy - an enlarged and thickened heart. It's the most common cause of sudden death among young athletes.

Ms. BABBITT: His heart was extremely thick. There was like a 95 percent chance that if he had an EKG that would have shown up, because the progression of the disease within John, at that time, was quite significant.

KNOX: An EKG, or electrocardiogram, is a $50 test. In Italy, every athlete - from elementary school through the pros - must have an EKG before he or she can play sports. Those with abnormal EKGs get other tests to see if their hearts are structurally abnormal.

Dr. ANTONIO PELLICCIA (Scientific Director, Italian Institute of Sports Medicine and Science): The Italian experience clearly demonstrated that screening is feasible and also is very efficient.

KNOX: Dr. Antonio Pelliccia is with the Italian Institute of Sports Medicine and Science. He's an author of the study on the 26-year-old Italian screening program. Researchers followed 81 athletes with severely abnormal EKGs. Over nine years, five developed cardiomyopathy, one died suddenly, another survived a cardiac arrest. So a severely abnormal EKG does sometimes predict later heart disease. Some had thought an abnormal EKG could be a harmless result of athletic training.

But Dr. Barry Maron says that doesn't mean all U.S. athletes should, or could, get EKGs.

Dr. BARRY MARON (Director, Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation): I wouldn't want to put a price tag on a young athlete's life that, you know, could be saved through screening. The issue is resources and the practicality. It just can't be done in the United States.

KNOX: Maron, for the Minneapolis Heart Institute, is also an author of the new study. He says sudden death in apparently healthy young people occur, on average, once a week. It seems like a big and scary problem because these tragedies are getting increasing attention.

But out of the young athlete population of 10 million or more, Maron says it's actually pretty rare. And, he says, screening everybody would be prohibitively expensive.

Dr. MARON: It's hard to know exactly, but it could be as much as $2 billion a year.

KNOX: Lisa Salberg was diagnosed with cardiomyopathy when she was 12. Her father has it, her daughter has it, and it killed her sister. She founded a group called the Hypertrophic Cardiomyopathy Association. But she's not for universal EKG screening.

Ms. LISA SALBERG (Founder, Hypertrophic Cardiomyopathy Association): There are some people that will say, to save a life if it costs $1 million per person, we should do it.

KNOX: She thinks it's more feasible to tighten up screening programs already in place than ask parents to disclose any family history of premature cardiac death. But that's not fullproof.

Ms. SALBERG: Unfortunately, I'll tell you, that some families choose purposely to not disclose information about family history for fear of being disqualified from competition.

KNOX: And Dr. Barry Maron says neither high school, nor college athletic officials have shown any interest in programs that tell some young athletes that they can't play.

Richard Knox, NPR News.