Do Kids Need an EKG Before Playing Sports?

Kids are bursting with energy. They make jumping, running, or diving for a ball look easy. With the way they move, it’s hard to believe that some children have an undetected yet life-threatening heart condition.

The Centers for Disease Control and Prevention (CDC) estimates that 2,000 people under age 25 die each year from sudden cardiac arrest. Sudden cardiac arrest (SCA) — when the heart suddenly stops beating — is rare. But, says Melissa Diamond, MD, a pediatric cardiologist with Joe DiMaggio Children’s Hospital, the majority of SCA cases in kids occur while playing sports.

Though not mandatory, many organizations have begun including electrocardiograms (EKGs) in the physicals required for their athletes. EKGs can detect signs of conditions linked to SCA.

“It’s a newer trend to do a screening EKG during a sports physical,” Dr. Diamond says. “Previously, you may have seen a cardiologist for an EKG only if there was something in your family history or if you had a symptom.

“EKGs don’t catch everything, and a normal EKG doesn’t necessarily mean your child will never have a heart problem, but EKGs can go a long way toward keeping kids safe.”

What is an EKG?

An EKG, sometimes called an ECG, is a simple, painless test that informs doctors about how well the heart works.

An EKG test uses a machine to produce pictures resembling wavy lines across the page. These lines represent the electrical signals sent from your heart.

Doctors look for abnormal areas along these lines. Things that cause an abnormal EKG include:

• Irregular heart rate – when your heart beats too fast or too slow
• Irregular heart rhythm – skipped heartbeats or flutters

What to Expect During an EKG

During an EKG, you will lie on a table. The person performing your screening will place stickers, called electrodes, on your chest, arms and legs. Then, they attach wires (leads) to the stickers. A machine connected to the leads will read how your heart works while you relax on the table.

An EKG takes just a few minutes to complete.

It’s important to know that the leads don’t pinch your skin, and the stickers peel off easily after the test.

You don’t need to do anything to prepare for an EKG. During the test, boys remove their shirts, and girls can wear a scoop-neck tank top or a sports bra.

What if Your Child’s EKG is Abnormal?

An abnormal EKG doesn’t always mean your child has a heart problem. But, if your child’s EKG is abnormal, they should see a cardiologist to rule out certain conditions.

“An EKG can give us information about the heart’s size or tell us if there could be a problem with the heart’s electrical system,” Dr. Diamond says. Abnormal EKGs can be signs of several heart conditions, including:

• Arrhythmia: A heart rhythm disorder.
• Congenital heart disease: Heart conditions present at birth.
• Hypertrophic cardiomyopathy: Thickening of the heart muscles.

If your child’s EKG is abnormal, a cardiologist may recommend additional tests, like a heart ultrasound or stress test. A heart ultrasound, also called an echocardiogram, provides moving pictures of the heart. Your child’s doctor uses these pictures to check the heart’s size and shape. A stress test monitors how the heart functions during physical activity.

Signs and Symptoms of a Heart Problem

Whether or not your child has had an EKG, you should still watch for symptoms of a heart problem. Coaches should also be on the lookout for signs of a heart condition. These include:

• Abnormally fast heart rate or feelings of a racing heart
• Chest pain
• Dizziness
• Getting tired faster than usual during athletic activities
• Shortness of breath beyond what’s typical during exercise

“Coaches and parents tend to push kids to work hard,” Dr. Diamond says. “It’s important that we listen to them, watch for things that just don't seem right and make sure they are getting plenty to drink.”

The pediatric cardiology experts at Joe DiMaggio Children’s Hospital diagnose and treat conditions affecting your child’s heart. Learn more about our pediatric cardiology services.