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Proposed bill would add cardiac evaluation to school sports physicals

Republican Sen. Waylon Brown proposed the measure, saying a constituent reached out and was concerned the current health checkup was not extensive enough.

Before Iowa student athletes compete, they're required to get a sports physical. But thanks to Senate File 87, that physical could one day include a cardiac evaluation. 

The proposal comes from Republican Sen. Waylon Brown, who says a constituent expressed concern these physicals may not be extensive enough to identify underlying cardiac conditions in young athletes.

The measure is currently assigned to the Senate Education Subcommittee. 

"The overall incidence of sudden cardiac death or serious cardiac arrhythmia that could cause an athlete, or even a nonathletic child, to have a collapse or an arrhythmia is one in 40,000," said MercyOne cardiologist Dr. Denise Sorrentino.

Sorrentino believes the increased awareness and testing would be positive, however she says it would create an incredibly high volume of testing for providers like her to not only conduct, but read. 

"There certainly needs to be funding," Sorrentino said. "There needs to be a way to do it, including for those athletes who may not have optimal health insurance or access to medical care. There's still variation in who has access. But if the state is going to make a regulation, we need to make sure everybody has access to this type of evaluation, including the EKG and reading it."

While Sorrentino says the incidences of serious heart conditions in young people are slim, she says no coach or parent wants to take that chance on their athlete — which is why she's encouraging athletes to pay attention to their family history and to speak up if they feel off. 

"If they're feeling pain, pressure, tightness in their chest, racing, irregularity, dizziness, lightheadedness. A lot of athletes don't want to say this, because they don't want to be pulled from the game or the starter lineup. But it is in their best interest to heads up their family, their coach or their trainer, step out and be evaluated," Sorrentino said. 

Vic Miller, associate director of athletic training at Iowa State University and president of the Iowa Athletic Training Society, said a type of cardiac screening is already included in the preparticipation physical exam. 

"If the medical provider is qualified and is taking the initiative to complete each exam in its entirety, this will be an adequate screening," said Miller. "Adding the requirement is, first, not necessary because it already exists. Second, requiring a more thorough examination that involves diagnostics or specialist visits could be difficult logistically and published research shows there are likely to be far more false positives than actual pathology to be found with more in-depth testing."

While many people became aware of cardiac events following the sudden collapse of Buffalo Bills player Damar Hamlin, Miller says pre-participation screening is not what saved his life. 

"Instead, it was the response to his condition that led to his survival," said Miller. "There are more than two dozen specialty personnel present at each NFL game who have a primary role in treating a cardiac patient. This team involves paramedics, athletic trainers, physicians and equipment that work based on a well thought plan that was implemented this past season in Cincinnati."

Miller adds: "Athletic trainers, as well as other first responders, would much rather see well thought out, detailed and rehearsed emergency action plans in place for all youth activities. This should include detailed and rehearsed action plans, trained personnel, emergency response equipment (like AEDs or severe bleeding kits, etc.) and venue-specific roles and responsibilities for Coaches and administrators. The perfect person to create, monitor and carry out this type of response is an athletic trainer. All school districts that choose to support athletics or other activities should reflexively choose to have an athletic trainer present or employed within the school district."

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