A “100-year-old” test is still the gold standard for preventing sudden cardiac death

Results of a new survey show public awareness of the humble ECG is good…but more needs to be done.

A new opinion poll for the charity Cardiac Risk in the Young (CRY) has revealed that around two-thirds of people (62%) are aware that an ECG (electro-cardiogram) could detect the majority of conditions which can lead to young sudden cardiac death.

The 12-lead ECG test (which was first developed at the turn of the 20th century, with its rollout as diagnostic tool routinely seen in hospitals from the 1950s) is currently recognised by many experts as the “gold standard” test for identifying cardiac abnormalities and signposting a need for further investigations such as echocardiogram scanning, MRI and genetic testing.

Yet, to the dismay and anger of the 1,000s of families who have been so affected by the sudden and seemingly inexplicable cardiac death of a child, partner, sibling or friend, Government appointed advisors continue to dismiss the scale of these tragedies as “tiny” and “rare” and have not yet commissioned a national strategy for the prevention of young sudden cardiac death.

It is widely acknowledged by cardiologists, coroners and key influencers that every week in the UK, at least 12 young (aged 35 and under) people die suddenly from a previously undiagnosed heart condition. In the vast majority of cases, the first sign of a problem will be the last sign and therefore the only way to detect a potentially fatal cardiac abnormality is through proactive cardiac screening by specially trained cardiologists, using an ECG.

Of the 18-34 age group questioned as part of the UK-wide survey, over two-thirds (67%) of men and 71% of women said they would like “the opportunity to book in for cardiac screening (with an ECG) before reaching the age of 35”. 

When asked, 60% of parents of children aged 14-35 (the current age criteria for CRY’s screening programme) said they would actively encourage their children to be tested. Of those who were unsure (28%) or who said they would not actively encourage screening, (just 13%), the most common reason (35% or, one in three) was because they felt their child was fit and healthy and therefore didn’t see the need – contrary to the shocking reality that in 80% of cases of young sudden cardiac death there will have been no warnings or symptoms.

Although screening (via a health questionnaire and ECG) will not identify all those at risk, in Italy, where it is mandatory for all young people engaged in organised sport, the incidence of YSCD has decreased by a staggering 89%. 

CRY firmly believes that every young person should have the choice to be screened and currently offers a national screening service where anyone aged 14-35 can access free cardiac tests. As such, CRY’s expert teams currently test around 30,000 young people every year – with community screenings across the UK accessible in just 3 clicks @ www.testmyheart.org.uk.

There also appears to be a significant misunderstanding of the possible causes of sudden cardiac death with 40% of people (rising to 52% among 18-25-year olds) incorrectly believing that an unhealthy lifestyle could be a major contributory factor of these tragedies.

Dr Steven Cox, Chief Executive of CRY, comments; “Crucially what this survey has flagged up is there is still a need for organisations such as CRY to continue educating young people, their parents and policymakers about any continued misconceptions about cardiac screening, how we can identify these conditions and essentially, who is at risk.

 “These people are young, vibrant, physically active and in the prime of their lives when they die, so suddenly. That’s why cross-party support for a new national strategy is so crucial, ensuring that the guidelines and policies to prevent young sudden cardiac death are consistent and that those making the decisions are fully informed of the efficacy of the available tests, have access to the international evidence supporting it and understand the health economics surrounding screening.

“We know that at least one in every 300 young people tested by CRY, with an ECG, will be identified with a potentially fatal heart condition that needs urgent investigation. 

“The ECG is a routine first test when a Dr is concerned about a patients’ heart. The reality is this is usually only offered to older people. Why should young, apparently fit and healthy young people, who may be harbouring a hidden time bomb, not have access to the same, simple, lifesaving test?”

1A survey was conducted among 2,001 UK adults aged 18+. The research fieldwork took place between 18th-22nd October 2018.