The sudden cardiac death of young people could be prevented by a basic screening programme costing just £35, say experts.


Some high-profile deaths of young sportsmen have led to calls for routine tests to check for any heart abnormalities.

The new study by heart specialists at St George’s, University of London, has shown that screening for abnormalities can be cost-effective and would save lives.

Experts at presented their results at the EuroPRevent 2014 conference in Amsterdam after studying more than 12,000 cases aged 14 to 35 that demonstrated that the tests could effectively screen each person.

Subsequent referral to a speciality centre for further investigations was low and considered of "a relative low additional cost" to health services.

Dr Rajay Narain, from the Department of Cardiovascular Sciences at St George’s, University of London, said most cases of Sudden Cardiac Death (SCD) were a largely the result of inherited cardiac conditions which could be detected via checks.

While in totality such cases are relatively rare, the case of Bolton Wanderers footballer Fabrice Muamba who eventually survived a cardiac arrest drew national attention in 2012.

Dr Narain said: “To prevent such tragedies, sporting and scientific bodies recommend pre-participation screening in young athletes.

“However, this approach is controversial because of significant costs given that the actual numbers at risk is small. Moreover, most SCDs in the young are likely to occur in non-competitive athletes. Despite their rarity, each and every event is an absolute tragedy; they very visible, particularly when high-profile athletes are involved.

“The cardiac arrest of the footballer Fabrice Muamba last year is just one example of the societal impact of such potential tragedies. It was thus our aim to see if population screening was feasible in this age group.

"Most developed countries have the potential for creating a screening system in high schools similar to that established for immunisation programmes. There is evidence that teachers, coaches and even volunteering parents could be trained to interpret ECGs. The incentive is judicious - 25–30% of the population in the Western world is now aged 18 or under."

The study involved the young people irrespective of their athletic ability. Only 13% were considered elite athletes.

Results showed that almost one-in-ten of the population (9.4%) were sent for echocardiographic heart imaging on the day, and 2.7% (323 individuals) were referred for further assessment.

The £35 screening assessment involved a health questionnaire, an electrocardiogram and a consultation with a cardiologist.

Of these who responded to the questionnaire and completed their follow-up investigations (189), a cardiac abnormality (or findings necessitating regular follow-up) were identified in 31 (16%). The most common were heart block (slowing of the heart rhythm)(10), an irregular heart rhythm (9) and abnormality of a heart valve (6). Different cardiomyopathies (abnormalities of heart muscle) were evident in 11 cases.

Dr Narain said the concept of early identification of potential victims is contentious, with concerns about costs and the need for multiple tests to identify complex problems, as well as medical and legal implications for false positive or negative results.

But he said a screening programme could mean many sudden deaths from these conditions, which may account for up to 15 deaths a week in the UK, could be prevented.

Dr Steven Cox, of charity Cardiac Risk in the Young Heart Screening Charity (CRY), said: “This research is a snapshot of one year of testing at CRY. Last year we tested almost 14,000 young people and the programme is expanding.”