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Tuesday, August 5, 2008
Heart screenings can ease the pain, but not completely
The Atlanta Journal-Constitution
Dr. Robert N. Vincent listens to a patient’s heart with his eyes closed.
He takes a breath, closes his eyes, then places his stethoscope against the patient’s chest. He listens for the sounds and murmurs of each valve.
Vincent is a pediatric cardiologist at Sibley Heart Center of Cardiology in Atlanta. He’s my son’s cardiologist. Now 12, Miles had heart surgery at 5 days old to correctly reattach his arteries. He has to have his ticker listened to and photographed every now and again to make sure everything is in order.
Vincent expects his office, as well as those of his peers, to be flooded with inquiries over the next few days. It happens every time a teen athlete dies, as was the case recently in Gwinnett.
Jahceem Xavier, a 13-year-old boy from the Snellville area, died last Monday after his very first practice in the Gwinnett Football League. The county medical examiner’s office believes it was a heart attack. Jahceem had an enlarged heart, a condition many believe would have been detected with an echocardiogram, basically a heart screening.
With the death of Jahceem, concerned parents and coaches think it’s time for high school sports teams and recreational leagues to start offering heart tests. The test costs thousands of dollars, but UltraScan, a business in Suwanee, stands willing as part of a charity to provide the exams for $58.
Of course this is a good idea and would be a great service, but with drawbacks - false positives and false negatives being two of them. The biggest negative of all, though, may be the false security such a screening would give parents and teens.
An echocardiogram, Vincent told me, can only detect certain conditions, one of the more common being hypertrophic cardiomyopathy - or thick heart muscle. But there are several other underlying conditions in the sudden cardiac death of teens that screening by echocardiogram won’t detect.
“You’re fooling yourself if you think that all the other causes of sudden cardiac death in teens can be picked up in the echocardiogram,” he said. “It takes more than that. A good medical history and a physical and an electrocardiogram are probably just as good at sorting these things out, if not better.”
Vincent doesn’t object to heart screenings for athletes. Like me, though, he wants a community that’s emotionally torn up by the loss of Jahceem to be realistic. To realize that screenings will detect some abnormalities and save some lives, but definitely not all.
Vincent compared heart screenings to the use of seat belts. When you ease onto I-285 and traffic is flowing at 80 miles per hour - with people yakking on cellphones and tuning radios and putting on make-up - there’s only so much of a safety net a seat belt can provide.
Same for echocardiograms.
Rick Badie’s column appears on Sundays, Tuesdays and Thursdays. Contact him at 770-263-3875 or e-mail: rbadie@ajc.com.
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