Cardiac screening: is it time for new programmes to save young lives?

Posted: 21/03/2019

Every week in the UK around 12 young people die of an undiagnosed heart condition. Many will be fit, healthy and active with no awareness that anything is wrong meaning there is no opportunity to intervene sooner to prevent such fatalities.

Although a number of screening programmes are funded by the Government, cardiac screening for the young is not one of these.

One of the most common investigations that is carried out to test for various heart conditions is an electrocardiograph (ECG). This can be invaluable in achieving an early diagnosis which could potentially save someone’s life.

Numerous stories appear in the press of young, fit and active people who have passed away due to a cardiac arrest whilst competing in sporting events such as marathons and triathlons. An inquest at the beginning of March considered the death of a 31-year-old man who collapsed during the Wilmslow half marathon whilst in Cardiff the Coroner has recently investigated the cases of two men, aged 25 and 32, who went into cardiac arrest and later died after the city’s half marathon last year.

The question is, therefore, should an ECG be offered to young people at certain stages of their lives and, particularly, anyone who is taking part in any form of sporting activity or event?

The message of keeping active and fit in order to sustain a healthy lifestyle is constantly pushed forward in the media and there is no doubt that such measures are key to ensuring other diseases and conditions are prevented. It is surely therefore important that young people are not deterred from taking part in such activities for fear that an underlying heart condition may prevent them from doing so. 

Cardiac Risk in the Young (CRY) is a charity that helps raise awareness of the value of a simple ECG investigation in saving the lives of young people. It offers subsidised ECG and echocardiogram screening to all those between the ages of 14 and 35.

These screening sessions are not publicly funded by the Government in any way and are only possible as a result of the hard work and tireless fundraising of the supporters of CRY.

But what exactly are ECGs and echocardiograms and why are they so important?

Understanding the basics of an ECG

An ECG is a test that uses a machine to record the heart’s rhythm onto a paper after electrodes have been placed on the patient’s chest, arms and legs. The electrodes detect the electrical signals produced by the heart each time it beats. The recording on the paper will then be analysed by a doctor who is able to determine whether the heart muscle is damaged or short of oxygen.

There are also several specialised ECG tests that can be carried out to investigate further any concerns. These include an exercise tolerance test where the ECG scan takes place whilst the patient is exercising and resting, and a cardiac holter monitor which is a portable ECG machine, usually worn for 24 to 48 hours to monitor the heart rate and rhythm over a period of time.

A doctor may decide to perform an ECG if a patient reports symptoms such as chest pain, palpitations, dizziness or shortness of breath.

However, the screening carried out by CRY is undertaken to reveal underlying heart conditions in young people who sometimes never show any symptoms until, unfortunately, they suffer either a heart attack or a catastrophic cardiac arrest.

Given that some heart conditions may not be detected for many years due to the fact that they do not cause patients to present with any symptoms, ECG screening can be a vital tool in saving the lives of people who are unaware that they have an undiagnosed heart condition.

At Penningtons Manches, the clinical negligence team deals with a range of claims relating to incorrect cardiac treatment or failures to diagnose serious cardiac conditions. The team therefore understands the devastating effect untreated cardiac conditions can have on patients and their families.

Senior associate Emma Beeson, who is a member of the firm’s cardiology sub-team, explains her own experience of undergoing an ECG:

“The test is a completely painless investigation. You are required to take any clothing off the top half of your body and sticky electrodes are placed onto your arms, chest and ankles. The test can take a few minutes whilst the machine monitors your heart activity but it is over relatively quickly. Once the machine has produced a reading, this is analysed by a cardiologist who can determine whether further investigation is needed. 

“It is very important when acting on a claim relating to a cardiac injury that we have access to the ECG results if any such investigations took place. Although they have similar names, echocardiograms and ECGs are often confused and patients sometimes believe they have had an echocardiogram when they have, in fact, only had an ECG.

“An echocardiogram (echo) is similar to an ultrasound scan. It uses sound waves to study the structure of the heart and assess how, not only the heart muscle is working, but also whether the valves of the heart are functioning correctly.

“As someone who knows all too well the impact of losing a loved one from an undiagnosed cardiac condition, I believe it is vital that awareness of the risk to young people should continue to be raised. The topic of whether or not ECG screening should be something that the Government considers funding needs to be given serious thought.”

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