New program aims to help save young
athletes from sudden death
HOUSTON – (May 6, 2009) – Adrian, William, Jocelyn and Kailynn—all athletic teenagers from the Greater Houston area and all victims of sudden cardiac arrest.
Hannah Padilla undergoes testing to scan her heart for any underlying conditions.
Adrian and William survived. Jocelyn and Kailynn, both just 13, did not.
“In each of these cases, the problem that caused the sudden cardiac arrest could have been detected with more in-depth screening than typical athlete physicals,” said John P. Higgins, M.D., assistant professor of medicine at The University of Texas Medical School at Houston.
Less than one in 10 U.S. student-athletes who suffer sudden cardiac arrest survives, according to a 2008 study in the HeartRhythm Journal. Sudden cardiac arrest is a condition in which the heart suddenly and unexpectedly stops beating. When this happens, blood stops flowing to the brain and other vital organs. It usually causes death if it’s not treated within minutes.
Higgins, a cardiologist and exercise physiologist, is now the principal investigator of a study and pilot program launched by the UT Medical School at Houston and the Memorial Hermann Healthcare System to prevent tragedies like the deaths of Jocelyn and Kailynn. It’s called HEARTS™, which stands for Houston Early Age Risk Testing and Screening Study.
HEARTS™ is a free, four-step program that includes a self-administered questionnaire, cardiovascular physical exam, 12-lead electrocardiogram (EKG) and echocardiogram (cardiac ultrasound) of sixth-grade students to detect potential heart problems. The process takes about 15 minutes.
John P. Higgins, M.D. discusses the results of the testing with Hannah and her parents.
“It’s around sixth grade that kids become more active and often get into sports on a more serious level,” said Higgins, director of exercise physiology at the Memorial Hermann Sports Medicine Clinic. “Once they get into the really competitive sports, the heart will be under a lot of stress. And kids are so young that many wouldn’t think to check them for underlying heart problems.”
The first phase, HEARTS™ over Houston, will begin in May at a school in the Houston Independent School District (HISD). The sponsors of the program include the Houston Division of the American Heart Association and the Houston Rockets.
This fall, a UT Medical School team will travel to more HISD schools with all of the necessary scanning equipment. Approximately 1,500 students will be screened during the first phase. If a problem is observed during the exam, Higgins said the student will be referred to pediatric cardiologist Gurur Biliciler-Denktas, M.D., assistant professor of pediatrics at the medical school, for further testing and management at UT Physicians’ pediatric cardiology clinic at The University of Texas Professional Building in the Texas Medical Center.
Hypertropic cardiomyopathy – an abnormal thickening of the heart muscle – is the leading condition that causes sudden cardiac arrest among young people.
“No child will be turned away for lack of insurance or money. This program is not just about detecting a possible problem. The program also includes treatment,” Higgins said. “The goal is to get to these kids early, especially before they begin high-intensity sports. The program is not exclusive to athletes. We will be screening all sixth grade students.”
Hannah Padilla, 12, can speak to the importance of early screening. She is active in about a half-dozen sports, including volleyball, track, cheerleading and tennis.
“She just keeps going and going,” said her mother, Connie Padilla. “The only time she’s still is when she’s at the computer doing that MySpace thing. She’s always been active.”
Last fall, Hannah’s parents decided to have their daughter screened at the Memorial Hermann Heart & Vascular Institute-Texas Medical Center.
During an ultrasound of Hannah’s heart, Higgins explained everything he was seeing on the monitor.
“We are looking at the size of the heart to see if it’s dilated,” Higgins explained. “We want to make sure that it’s not too thick. So far it’s looking good.”
Next, he viewed the aorta, looking for signs of weakening or enlargement. Either condition may indicate Marfan syndrome, a disease where the muscle tissue weakens so much that the artery enlarges and can rupture, causing serious heart problems and even death. Hannah showed no signs of the condition.
Higgins signed a slip clearing her to participate in sports since the screening didn’t indicate any major problems associated with sudden cardiac arrest.
But it did reveal something else.
“Overall, things look good,” Higgins explained. “However, Hannah does have a very, very tiny hole in her heart, almost microscopic, and it’s just below the aortic valve.”
Higgins explained that the condition, known as a ventricular septal defect (VSD), is a common congenital heart defect present in about one in every 200 children. In many cases, as the child’s heart grows, it disappears. To ease their fears, he suggested that they consult with a pediatric cardiologist.
Connie Padilla was a little shaken by the news.
“I think what Dr. Higgins is doing is great,” Connie Padilla said. “A lot of teens who are into sports need this. I’m glad that he cleared her to participate in sports; although to find out about this hole is a little strange. But we wouldn’t have found out about it if we hadn’t done the screening.”
Higgins’ study will include compiling all of the data obtained during the pilot program to improve the screening process. His goal is to one day expand the program beyond Houston.
“We want to save lives and catch underlying heart disease early,” said Higgins. “We don’t want any more new names in the headlines.”