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Medically Reviewed by Jason Ho, MD

Winter and spring sports are gearing up for high school and college students. And, where an unknown heart issue is present, this could put your student at risk for cardiac arrest.

A cardiac arrest can happen quickly and without warning. In fact, it is reported that a young, competitive athlete dies suddenly every three days in the United States. For young athletes, the risk is twice that of non-athletes.

A simple, non-invasive test called an electrocardiogram (EKG/ECG) can help to identify potential life-threatening conditions.

Read on as WakeMed pediatric cardiologist Jason Ho, MD, answers your questions about EKG screening.

What is an EKG?

An EKG is a simple, painless and non-invasive test that records heart rate and rhythm. It’s basically an electronic snapshot of the heart’s activity.

Who can and should participate in an EKG screening?

Any child can participate in an EKG screening. Those with a family history of cardiac issues should consider having their child screened. In addition, those participating in athletics, such as team sports or other individual athletic activities — including cycling, running, rock climbing, kayaking or dancing — should consider screening. Ideally, every child should undergo some form of screening before participating in athletics. Typically, this involves a review of symptoms and family history. Those with concerning findings are then referred for additional screening which involves an EKG.

Why do you recommend screening for young athletes?

The risk of sudden cardiac arrest for young athletes is twice that of non-athletes. For this reason, parents play a vital role in ensuring their young athlete is screened.

“We are potentially able to catch unknown heart health concerns in athletes and guide them to additional testing, treatment and possibly life-saving procedures,” says Dr. Jason Ho, WakeMed Pediatric Cardiologist.

What will happen at an EKG screening?

It’s pretty quick and easy. There is no blood draw or radiation.

“If we find anything of concern, we can do additional testing and provide a physician referral for the child.”

What would you like parents and youth to know before an EKG screening?

Parents and youths do not need to do anything to prepare for the screening. It does not take much time, and there is no reason to be overly worried.

Fortunately the results for most kids are normal, and the screening gives families a little extra peace of mind. However, the screenings can potentially catch previously unknown heart health concerns before a life-threatening situation occurs for a young athlete. Frequently, there are no symptoms despite the existence of a heart health condition that needs to be addressed, so these screenings can help prevent serious cardiac events and save lives.

Why should young athletes get a heart health screening?

A cardiac arrest can happen quickly and without warning; it doesn’t just happen to older adults. According to the National Institutes of Health, “sudden cardiac death is the most common medical cause of death in athletes.”

What else should parents and youth athletes know regarding their heart health?

Anyone with any of these symptoms during exercise should seek medical attention:

  • Chest pain
  • Fatigue
  • Fainting
  • Seizures
  • Trouble keeping up with others

And, young athletes who were born with a congenital heart disease or who have a family history of sudden death should definitely get their heart health checked before participating in athletic activities.

What heart health conditions are typically found during a screening?

Fortunately, most screenings are normal. An EKG can detect concerns, such as Long QT syndrome or Wolff-Parkinson-White, both of which can be life threatening. The biggest concern would be looking for any EKG changes suggestive of hypertrophic cardiomyopathy, which is the number one cause of sudden death in young athletes. While no youth athlete wants to be taken out of the game, the screening can help save lives and provide life-changing medical insight for a child’s overall health and future.

Most will be normal, but we can potentially find abnormalities that require further evaluation and may lead to a procedure, treatment or activity restrictions. Although it is not a common occurrence, a screening could find a serious concern that means a child should not play sports, but that finding is also likely to help prevent a life-altering incident or death.

For those with MyChart, the administering provider may post screening results there.

What proactive steps can be taken to prevent sudden cardiac death?

Regular well-child visits and sports physicals are an important step. Be sure to gather the heart health history of your relatives and share it with your child’s doctor and other health care professionals during check-ups and sports physicals.

What are some heart healthy tips?

Kids should be encouraged to remain active unless good reason exists to slow things down a bit. Follow these mindful tips to help keep athletes and the whole family healthy and in the game.

  • Swap out screen time for fun, outdoor adventures.
  • Stay hydrated by drinking water throughout the day.
  • Stock up on healthy snacks, help kids make healthy food choices, and offer well-balanced meals.
  • Stress the importance of steadily building endurance and strength versus overtraining.

Even though they are active, youth athletes can be overweight. Some think that bigger is better. They should be reminded that they can be strong, sturdy and competitive without being overweight. Wise food choices can help prevent future cardiovascular problems, diabetes, sleep apnea and more.

Contact a provider if a child reports chest pain or shortness of breath. A child with pain at rest is less concerning than pain while exercising. It is not normal to have chest pain with activity.

Schedule an appointment for an EKG screening.

Contact your WakeMed Primary Care provider or WakeMed Children’s – Pediatric Primary Care provider about scheduling a student EKG.

Meet the Expert

Jason Ho, MD, is a pediatric cardiologist with WakeMed Children’s – Pediatric Cardiology. He is a graduate of the Brody School of Medicine in Greenville, NC, where he remained to complete his residency in pediatrics, followed by a fellowship at Indiana University as well as a senior fellowship in pediatric electrophysiology at Vanderbilt. Dr. Ho brings a unique perspective to pediatric cardiology as his oldest child was born with a congenital heart defect and underwent surgery at 5 months of age. This experience allows Dr. Ho to relate to patients and their families on both a professional and personal level.


This blog is adapted from an article in our Families First Magazine. Interested in getting future issues of Families First delivered to your home? Subscribe here.

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WakeMed Heart & Vascular