Heart Screenings Can Save Young Athletes' Lives

TAKE IT TO HEART: For young athletes, chest pain or discomfort during activity should be checked out



Illustration by Vidhya Nagarajan

M  elissa Lankin’s heart was racing when she stepped off the soccer field one afternoon in late September 2007 — so fast that her mother couldn’t keep up while trying to count its beats per minute. The temperature had climbed to the mid 80s, so the athletic Royal Oak teenager thought her galloping heartbeat, faint feeling, headache, and painful jaw simply meant she was dehydrated.
 

She gulped water and a sports drink — the commercial blends contain salts like magnesium and potassium that perspiration can deplete, causing some symptoms like Melissa’s. But just to be safe, her mother, Karen Lankin, took her to the pediatrician the next day.

So began their two-year odyssey with doctor visits and tests that tracked Melissa’s heart’s electrical signals, made pictures of her heart using sound waves, had her run on a treadmill, and made her lug around a monitor that recorded the 24-hour activity of that vital organ for a month at a time. Whenever her heart started to zoom, a swig of sports drink and a doctor-prescribed maneuver to squeeze her knees to her chest usually slowed it down. Unfortunately, Melissa’s symptoms never surfaced in the presence of her medical detectives, making a diagnosis difficult.

The elusive diagnosis made Karen’s concern grow as she watched her daughter play the sports she loves. Both were aware of the occasional sudden deaths of young athletes across the country, sometimes from heart problems. 

During their quest for an answer, the Minnesota Heart Institute published a study of sudden, heart-related deaths in nearly 2,000 young athletes. About one-third was due to an inherited thickening of the heart walls known as hypertrophic cardiomyopathy. Another 20 percent was due to abnormalities present since birth in the artery that feeds blood to the heart. Could one of these be Melissa’s problem?

In November 2009, she learned she had made the girls’ varsity basketball team at Royal Oak High School, and her heart rate revved up again. “You could see my pulse beating out of my neck,” she says. The Lankins headed to the hospital, where attendants found her heart was roaring away at 160 beats per minute (60 to 100 is normal).

Doctors were finally able to come up with a diagnosis: supraventricular tachycardia. Fortunately, there’s a treatment for that. In December 2009, Dr. David Haines, a heart-rhythm expert at Beaumont Hospital, vaporized two tiny spots on the teen’s heart, the source of the alarming pounding. Weeks later, Melissa was back on the basketball court. She wore basketball jersey No. 40 for the Royal Oak High Ravens this past season. The teen, who turns 18 this month, says she still feels fine.

The Lankins’ story highlights steps that Dr. Pooja Gupta, pediatric cardiologist at Children’s Hospital of Michigan, wishes all families would take. Melissa told someone right away about her symptoms; her mother took the news seriously; and she wrote down pertinent details so she could relay them to doctors.

Gupta says many young people have chest pain due to what are commonly known as “growing pains,” which are no cause to worry. It’s having the pain during activity that is of concern, she says. The doctor wants everyone to know that medical help is called for when children pass out or have chest pain or discomfort while playing, or if they can’t play as hard as usual. This is especially important if a family member died of a heart problem at a young age, possibly a sign of an inheritable condition. In that case, even if a child has no symptoms, his or her heart should be checked.   

Gupta thinks children may underestimate the importance of their symptoms, or not tell anyone about them because they fear being sidelined.

Melissa agrees. She especially urges boys who may have been brought up to “suck it up” when feeling bad to tell an adult right away. “Don’t be afraid, because you’re putting your life at risk,” she says. “Don’t be like Superman.”

Such heart problems are common enough that Haines started a cardiac-screening program for high-school athletes in 2007. The “Healthy Heart Check” program has since expanded to include non-athletes, and has screened more than 5,000 children to date. It includes a questionnaire, heart exam, and electrocardiogram, which tracks the heart’s electrical signals.

Haines says the screening is adept at uncovering hypertrophic cardiomyopathy, a rare condition that may cause no symptoms but can result in sudden death. It’s what killed Wes Leonard, the Fennville, Mich., teenager who died suddenly in March after making the winning shot in a basketball game. A week later, a high-school basketball player in Texas died from the same thing.

Medical experts debate the merits of including ECGs in pre-athletic screenings, due to their cost and the number of false positives. The American Heart Association deems the measure costly, but the International Olympic Committee recommends it.

Beaumont’s answer to the false-positive dilemma is to look at the heart using ultrasound. In addition to uncovering other problems, heart ultrasounds — echocardiograms — eliminate 90 percent of false positives, Haines says.

For details on the next free “Healthy Heart Check,” visit heart.beaumonthospitals.com/student-screening. “It’s our ‘give back’ to the community,” Haines says.


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