In his excellent article on the debate regarding cardiac screening for athletes, Peter Vigneron remarks:

“Advanced cardiac screening can reduce the likelihood of sudden cardiac arrest, the most common cause of death among athletes. So why is it so controversial?”

We wonder as much!

The key to the controversy has to do with what perspective one adopts.

If one looks at the issue from a public health or population perspective, recommending mass screening for every athlete is logistically daunting, and potential problems (such as false positives and false negative test results) are likely to occur.  There is also an important socioeconomic dimension to the recommendation: who would pay for this?

On the other hand, if an individual athlete wishes to reduce his or her own risk of sudden cardiac arrest, there is no question that comprehensive, individualized testing is feasible and can avoid or greatly reduce the pitfalls of false positives and false negatives, because multiple tests are applied at once.  When performed by competent staff and interpreted by an experienced physician, these tests are extremely helpful to detect or exclude any underlying cardiovascular problem.

Furthermore, the cost of comprehensive screening does not have to be as onerous as Vigneron states.  He warns that an echocardiogram (ultrasound study of the heart) can cost up to $2000.  We provide the entire battery of tests for a fraction of that amount!Read more

We don’t mean to be Scrooges here!  While we certainly wish you a festive and wonderful Holiday Season, we also want to remind you that more of a good thing is not always better.  We are referring here to the effect that “large” quantities of alcohol ingestion may have on the heart, even on a healthy heart.

The term “holiday heart” was coined in the late 1970’s by doctors who studied patients admitted to the hospital for arrhythmia and who were also intoxicated with alcohol.  The admissions occurred more frequently on Sundays and Mondays, and there was a peak in incidence during the week between December 24 and January 1.  None of these patients had evidence of other heart problems, and the arrhythmia—usually atrial fibrillation—typically resolved as the alcohol intoxication resolved.  The doctors therefore suspected that the cause of the arrhythmia was binge-drinking on weekends or during Christmas week.Read more

Image attribution: via Pixabay Creative Commons CC0 Public Domain

The electrocardiogram (ECG) is by far the most commonly performed cardiac test.  You may have seen a picture of one in a book or a magazine, or you may have been drawn into the drama of this mysterious waveform, flashing periodically on a monitor during a tense moment of  “E.R.” or “House.”

Have you wondered what the ECG is truly about?

The following Q&A will demystify the test as we begin to reflect on how the heartbeat comes about.Read more

Cardiomyopathies are very common causes of exercise-related cardiac arrest in youth and young adults, but can occur to anyone at any age.  An unfortunate example is the case of a 45-year-old seasoned runner who collapsed during a marathon last November in Tennessee.  The autopsy revealed an unsuspected cardiomyopathy.Read more

We are delighted to have been featured in a San Francisco Chronicle article which highlights the rising interest in cardiac screening among athletes.  I was correctly identified as being among the growing number of cardiologists who believe that current screening tools are excellent and underutilized.

The article covered the subject of screening in general, so I would like to offer some additional information for clarification. Read more

While we strongly promote prevention of heart disease through screening and early detection, we also wish everyone to be educated about the symptoms that could indicate an active cardiovascular problem.

A meeting was convened in October 2012 by the American College of Cardiology’s subsection on Sports and Exercise Cardiology.  The proceedings from that meeting, entitled “Protecting the Heart of the American Athlete,” were just published.  Here are the highlights that deal with 5 common symptoms of heart disease in athletes.Read more