Diagnosing conditions causing sudden cardiac
death can result in utilisation of several diagnostic
modalities. These can range from something as simple as an ECG
to something as complex as an electrophysiological study. The
more tests that are performed, the higher the yield of picking
up something that causes sudden cardiac death. Letís just look
at the common causes of sudden death, these are the
cardiomyopathies and ion channel diseases. The ion channel
diseases certainly can be identified using an ECG, the
possibility of underlying cardiomyopathy can be identified with
an ECG alone. So at CRY we try to adopt a very pragmatic model
which is cost effective and we normally recommend health
questionnaire and ECG on the understanding that an abnormality
on any of these investigations will result in further tests
which CRY will fund.
We do offer echocardiography, obviously thatís
a second test in addition to the ECG and that will have a better
diagnostic yield. An echocardiogram will pick up things that an
ECG wonít, for example anomalous coronary arteries, a small hole
in the heart, a minor valvular problem. These things may be
more important for the very elite athletes as opposed to someone
who is just doing recreational sport. So we give that choice
and the choice of people doing ECG and ECHO is usually taken up
by pretty elite or financially endowed sporting organisations.
I personally donít believe itís mandatory to do both.
Please note: since this video was filmed, CRY's
screening activities at King's College Hospital and the Olympic
Medical Institute have been relocated to the new
CRY Centre for Inherited
Cardiovascular Conditions and Sports Cardiology, based at St
George's Hospital in Tooting.