Diagnosing conditions causing sudden cardiac death can result in utilisation of several diagnostic modalities. These can range from something as simple as an ECG to something as complex as an electrophysiological study. The more tests that are performed, the higher the yield of picking up something that causes sudden cardiac death. Let’s just look at the common causes of sudden death, these are the cardiomyopathies and ion channel diseases. The ion channel diseases certainly can be identified using an ECG, the possibility of underlying cardiomyopathy can be identified with an ECG alone. So at CRY we try to adopt a very pragmatic model which is cost effective and we normally recommend health questionnaire and ECG on the understanding that an abnormality on any of these investigations will result in further tests which CRY will fund.
We do offer echocardiography, obviously that’s a second test in addition to the ECG and that will have a better diagnostic yield. An echocardiogram will pick up things that an ECG won’t, for example anomalous coronary arteries, a small hole in the heart, a minor valvular problem. These things may be more important for the very elite athletes as opposed to someone who is just doing recreational sport. So we give that choice and the choice of people doing ECG and ECHO is usually taken up by pretty elite or financially endowed sporting organisations. I personally don’t believe it’s mandatory to do both.
Please note: since this video was filmed, CRY’s screening activities at King’s College Hospital and the Olympic Medical Institute have been relocated to the new CRY Centre for Inherited Cardiovascular Conditions and Sports Cardiology, based at St George’s Hospital in Tooting.