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Tuesday, September 14, 2010

Youth heart screenings offer reassurance for parents

This article is from Chicago Tribune: September 10, 2010: http://www.chicagotribune.com/news/local/northnorthwest/ct-x-n-heart-monitoring-20100910,0,3315955.story

Youth heart screenings offer reassurance for parents
By Karen Ann Cullotta, Special to the Tribune

Clutching her security blanket and whimpering softly, 5-year-old Erika Roemisch was clearly skeptical of the doctor's promises that the heart screening she was about to get would be perfectly painless.

Within seconds, fuzzy, monochromatic images from an ultrasound of Erika's healthy heart were beamed up to the echocardiogram monitor, and the cardiologist had good news for Erika's pediatrician father, Dr. Frank Roemisch.

"Screenings make sense when they're done by someone like a cardiologist, who knows how to interpret the results," said Roemisch, a Gurnee resident.

Roemisch was among dozens of parents who brought their children to the Advocate Condell Centre Club in Libertyville recently for a pair of noninvasive tests aimed at detecting hypertrophic cardiomyopathy.

As the leading cause of sudden cardiac death, HCM captured the nation's attention in January when the condition was linked to the deaths of both Chicago Bears defensive end Gaines Adams, 26, and University of Southern Indiana basketball player Jeron Lewis, 21.

Dr. Joel Okner, a Vernon Hills-based cardiologist who conducted the Condell screening with his colleague, psychologist Jeremy Clorfene, said many such deaths can be prevented by providing cardiac screenings for all children — athletes, and nonathletes alike — aimed at detecting what he calls a "ticking time bomb."

A genetic condition in which the heart muscle becomes severely thickened, HCM can cause a rapid rhythm called ventricular tachycardia, which, if the heart is not defibrillated within minutes, can be fatal.

Despite some critics' claims that rising health care costs and the potential for false-positive tests make universal cardiac screenings an unrealistic goal, Okner remains undeterred in his mission.

While the recent screening of 150 children in Libertyville did not detect any potential cases of HCM, Okner said out of every 500 screenings his team performs, they typically find one person who needs further evaluation for HCM.

"But if in two years we can save the lives of two children, it's worth it," Okner said. "It makes you ask, 'How do you not test children for this?'"

Dr. Robert Bonow, past president of the American Heart Association and the chief of cardiology at Northwestern University's Feinberg School of Medicine, said the universal cardiac screenings conducted in European nations like France and Italy would be nearly impossible to replicate in the U.S., however.

"We have to consider the implications of these screenings, when we already have a health care system overburdened by costs," Bonow said. "There's nothing wrong with voluntary efforts like this. If you're the family that experiences the tragedy, it's worth it. But I think we need to ask ourselves, 'Can our system afford this right now?'"

A study by Stanford University School of Medicine researchers, whose results were released this year, found that giving young athletes electrocardiogram tests could be a cost-effective way to identify those who are at-risk. Okner said his method, of using both an EKG and an ultrasound test, is more effective in detecting HCM — but also more expensive.

Though the screenings using both methods were offered the Libertyville event for a discounted $55, such tests can cost hundreds of dollars and are not typically covered by insurance. And, as Roemisch, the Gurnee pediatrician, noted: "The problem is, there are still a lot of parents out there who can't afford to pay even $55."

Kurt Gibson, associate executive director of the Illinois High School Association, said officials recommend that all student athletes have a record of a pre-participation sports physical exam on file at their school. But the association has no specific policy regarding heart screenings.

"We would never discourage any parent from getting their student athlete an EKG or echocardiogram, but it is clearly not a requirement," Gibson said.

At John Hersey High School in Arlington Heights, head athletic trainer Hal Hilmer said that while he is aware of other school districts across the U.S. offering athletes free cardiac screenings, he has not heard concerns about the issue from any local parents.

"There are booster clubs in the U.S. raising money for these screenings, but I've also heard that sometimes the tests are problematic, with false-positives that cause a lot of worry," Hilmer said. "Heart conditions in athletes are something you don't want to miss. But, right now, the funding is not out there, and the onus is back on the parents."

Waukegan parent Judy Holmes said she did not hesitate to bring her son Andrew, 15, a football and basketball player at Mundelein's Carmel Catholic High School, to the recent screenings at Condell.

"His athletic trainer told us about the screenings, and he highly recommended it," Holmes said. "Andrew just had a sports physical, but I still felt like, 'What if I don't do it, and something happens?' It was the safe thing to do, but I am surprised and disappointed to know this is not covered by insurance like other preventive tests, like my annual mammogram."

Okner and Clorfene will conduct cardiac screenings 10 a.m. to 2 p.m. on Oct. 10 at the Gurnee Centre Club, 1405 Hunt Club Road, Gurnee. For details, call 847-775-0015.

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