Why introduce a screening programme?

CRY’s screening programme will raise awareness about the fact that young people with undiagnosed cardiac abnormalities can die suddenly from heart problems.
Young sudden cardiac death is not as rare as many people believe. For example, research has shown that 1 in 500 people have Hypertrophic Cardiomyopathy (HCM) – a condition that can cause young sudden cardiac death.

At least 12 young people die suddenly each week in the UK of cardiac abnormalities. Many of these deaths are preventable. Many have had symptoms that have not been recognised.

Some will have gone to a doctor or hospital and been sent home without even having been given an ECG test.

The true cost-effectiveness of saving lives through ECG testing has not been properly understood.
It has been assumed that ECG testing is not cost-effective. Unlike other conditions that can result in young deaths, young sudden cardiac deaths are swift – these young people have not been under surveillance or on medication. What has not been evaluated is the silent suffering of the families who lose a relative in this way and the wider impact on the community (friends, colleagues, schools, clubs, etc).

Pre-participation screening saves lives.
Research in Italy compares statistics of sudden death from HCM with those of the mortality statistics in the USA from this condition. Studies from the USA have consistently found that HCM was the most common cause of cardiac arrest in young competitive athletes (up to 30%).

In the Italian study, HCM caused only one death among athletes but caused sudden death in the non-athletic population with a frequency similar to that found in the USA.

Information can save lives.
CRY’s screening programme will also disseminate information and educate about symptoms. Often people think they have heart problems when they do not. Sometimes they have symptoms but they do not realise their significance.

Identifying those at risk saves lives.
An essential requirement of the screening programme will be to fill in a questionnaire recording both personal and family history. A family history is considered particularly relevant if one or more close relatives has had a premature heart attack.

Personal history would be considered relevant if the subject has chest pain or discomfort, fainting or near-fainting, irregular heartbeat or palpitations on exertion, or if the subject had shortness of breath or fatigue on exertion that was out of proportion to the degree of physical effort.

Appropriate information reduces the risk of anxiety.
Although there is much concern that a cardiac screening programme will create unnecessary anxiety, our experience does not support this. Conversely, it suggests that cardiac testing offers young people the opportunity to discuss underlying worries and reassure themselves. Many have heard of “Sudden Death Syndrome” and been unable to identify any further information on what this means.
Where there has been a young sudden cardiac death in a community there can be enormous anxiety. These fears can be allayed by offering cardaic testing and appropriate information.

We need to ECG test all young people to be fully effective.
Although young sudden cardiac deaths in sport are those that hit the headlines, most of these sudden deaths occur outside the sporting arena. Many young sufferers who have unrecognised symptoms have already ‘de-selected’ themselves from participation in sport because their symptoms have not been understood and treated.