Texas schools consider heart ultrasounds for athletes

Paul J. Weber - Associated Press

DALLAS – Automated external defibrillators may not be the only heart-saving devices soon prevalent at Texas high schools.

With the bulk of campuses already stocking the laptop-sized machines - also called AEDs, which are the chief resuscitative tool for sudden heart failure - some school districts are now bringing cardiac screening equipment on campus in hopes of catching congenital problems before clearing students to play sports.

As early as May, school officials in the Fort Worth suburb of Keller plan to offer optional heart ultrasounds and electrocardiograms to athletes at their three high schools. Parents would pay the cost of the screening, and while Keller hasn't settled on a diagnostic service, most charge from $75 to $300 per student.

Neighboring school districts are also looking at providing cardiac screening tests, while in Austin, echocardiograms are already given at virtually no cost to students in the upscale enclave surrounding Westlake High School.

"I have a feeling it's going to be the new hot topic," said Jesuit College Preparatory School athletic director Bob Wunderlick, whose North Dallas private school requires parents to sign an electrocardiogram recommendation waiver. "This is something that is going to be discussed throughout the coaching associations, like steroids."

Earlier this week, the University Interscholastic League voted to require AEDs, which cost about $1,200 apiece, at all 1,300 of its member high schools. The issue vaulted to the forefront of the UIL's agenda after a recent rash of students who collapsed with suspected heart trouble, including three teenage football players who died in a 10-day span in Houston.

In September, Westlake offensive lineman Matt Nader, a top football recruit who had orally committed to play at Texas, collapsed on the sideline at a game and was revived with the help of an AED.

"The AEDs are absolutely essential, but those are for the after of what occurs," said Keller ISD assistant athletic director Becky Spurlock, whose district plans to eventually have upward of 55 AEDs. "If we can prevent it in the first place, and see the problems that are there, that's the key."

An echocardiogram is an ultrasound that provides a picture of the heart structure to cardiologists, who then look for cardiomyopthies and abnormalities in the valves. An electrocardiogram, better known as an EKG, detects electrical problems that an echocardiogram cannot.

In Italy, teenage athletes are required to undergo EKGs to play sports. Advocates of heart screenings for high school athletes have long pointed toward the country's unrivaled mandate, and studies have shown a decrease in sudden cardiac death of athletes by 89 percent since Italy adopted the measure in 1982.

Some doctors challenge those numbers, and all cardiologists point out that screenings don't detect all heart problems and can produce false positives. Even Nader, a 6-foot-6 senior who weighs 300 pounds, had no heart problems show up on cardiac tests done before and after his collapse.

"It's not a real exact test," said Dr. William Scott, chief of cardiology at Children's Medical Center of Dallas.

Not to mention that providing a cardiac screening for every athlete presents a steep financial burden for school districts already facing tight budgets. Some officials said schools would generally be reluctant to offer a service they knew not all their students could afford.

Bedford-based The Heart to Play recently stopped trying to get its mobile echocardiogram service inside schools after initial enthusiasm from district officials never ended with a contract. Kevin Rooker, the company's president, said he now focuses on screening individual athletes.

"We'd thought (schools) would eat it up," Rooker said.

Nader's cardiologist, Dr. Paul Tucker, said wholesale school screenings are possible - and affordable - so long as cardiologists donate the time to comb through hours of ultrasounds. His group, Texas Cardiovascular, has offered echocardiograms to students at Westlake and other Austin schools for $5, which Tucker says simply pays for a technician.

Tucker said only about one in up to 300 students will be flagged with a possible heart problem. But the slim chances of surviving cardiac arrest outside a hospital with no neurological damage - about 5 percent - makes it worthwhile, he said.

"You're talking about slim pickings here," Tucker said. "You can screen a whole school and not find anything. But there is one or two you might find, and you can prevent him from having a bad outcome."