In a Heartbeat

It was supposed to be a routine procedure. Sophomore Allie Libeer went to East’s physical night in 2013 in perfect health. No shortness of breath, no exhaustion after athletic activity. Nothing. Two heart surgeries later, Allie would realize the results from her Electrocardiogram (EKG) heart test performed at the physical night saved her life.

That night, Allie was diagnosed with Wolff-Parkinson White Syndrome from the EKG — a test that records the heart’s electrical activity and can detect abnormalities. Cardiologists at Children’s Mercy say her condition would have been fatal if left unknown. They emphasized that the most concerning part about her issue was that she showed no symptoms.

“I didn’t believe them [at the physical night],” Allie said. “Nothing ever happens to me, so I denied it. But when I went to Children’s Mercy, they told me my life expectancy was not high at all and that the EKG actually did save my life. I could have easily passed away in my sleep.”

Allie is just one example of an issue that continues to be an unseen danger for teenagers. According to Athletic Testing Solutions, a company that will be coming to East to run heart screenings in November, sudden cardiac arrest from heart conditions kills 130 youth a week.  Heart conditions are the fifth greatest cause of death in teenagers in the U.S.

ATS and the SMSD Athletic Director Matt Johnson agree that the main concern is not the heart issues themselves. It’s the lack of awareness and resources to manage these problems. Pre-participation physical evaluations are often not thorough enough to check for heart issues, and little emphasis is placed on heart health among teens. Starting this year, ATS is working with Johnson to bring resources to check heart health in the district.

“Being a teenager is the time in your life when you feel so invincible, it’s hard to convince teenagers to get their heart checked when they have always felt great,” Johnson said. “It’s frightening to hear that, but awareness is the message that’s got to be sent.”

On Nov. 22 East will be the fourth district high school Johnson has arranged to host heart screenings by ATS. These EKGs and sonograms, administered by specialized cardiologists, can help detect and diagnose heart issues in any student aged 10 to 18, athlete or non-athlete, in the East area who attends.

The clinic will test up to 60 students for $99 as opposed to rates that can be up to $1,000 at a physician’s office.

Johnson scheduled these clinics to make up for the tendency of students to overlook their heart health during routine physicals. The purpose of routine physicals is to medically clear athletes for participation, reduce risks and make sure there are no pre-existing conditions to be worried about. But these physicals don’t include cardiac screenings.

Kansas law does not require a medical doctor to sign off on pre-participation physicals. Anyone from a nurse practitioner to a chiropractor can sign off on the form, prompting ATS and district personnel to call into question how thorough these requirements really are.

“My opinion of Kansas sports physicals isn’t very high,” ATS Director of Clinical Operations Eric Schroeder said. “When you look at who can sign off on a sports physical, it’s not the best. But you have to have access for everyone, it’s got to be a broad rule. We need to take it out of their hands and bring it back to specialists.”

Allie’s mother Jennifer would never have thought to get Allie tested at their primary care physician for any kind of heart abnormality. The only reason Allie got her EKG was because East was offering an EKG screening option at the annual physical night two years ago. Now, EKG tests at physical night have been replaced by the ATS clinic, but the underlying message still stands: students need to take advantage of the resources provided, to check their heart health.

“Kids don’t die from bad knees or sprained ankles, but they certainly die from heart problems,” Schroeder said. “Those are the things that get looked over the most in the physical. The question is not whether or not to make [heart testing] mandatory, but what is the most manageable way to test kids. To at least provide kids with the resources and forum to get tested.”

In a single moment an athlete can pass away in their sleep, or go into sudden cardiac arrest during a game from conditions like Allie’s, that are asymptomatic. Making local headlines on Sept. 27, an Overland Trail middle schooler went into sudden cardiac arrest at a cross country meet. He was medically pronounced dead on the scene, before being revived by medical personnel on the sidelines of the race, according to reports by KMBC 9 News.

Following this incident, Johnson and ATS staff members are trying to urge parents and students to take preventative measures. Johnson asks that parents and students be proactive instead of reactive, and take the steps to get checked, even if all seems normal.

The first ATS clinic at SM West took place a week after the middle schooler went into cardiac arrest. Just one day after it was scheduled, all spots were filled.

But while most members of the medical community agree that testing can save lives, EKGs are not yet endorsed by the American Heart Association, or National Athletic Trainers Association. They have not come to a consensus on whether or not EKGs should be mandatory prior to athletic participation, because there are arguments on both sides.

In an email statement, NATA declined to comment on the issue, citing it as a “controversial” topic that they were not comfortable making a judgement on.

While parents think making heart tests a mandatory part of the pre-participatory process seems like a good solution, Johnson and East Athletic director Kelli Kurle both agree it is not feasible at this time. Instead, they will focus on spreading awareness, and providing opportunities for people to get the checks if they are interested.

“It would be hard to make [EKGs] mandatory because of the cost and resources to do it,” Johnson said. “Physicals weren’t always mandatory, and they cost money too, so I see more comprehensive physical testing of athletics in the future, even if they are never officially mandatory.”

But Jennifer Libeer knows first hand what an EKG test can mean to a family. Sometimes, she watches Allie playing tennis, or sits next to her at dinner and realizes that it is a serious possibility that Allie might not have been with them today. If she had not gotten the EKG that night, she might never have discovered her severe condition. She might have died.

Jennifer’s words to parents and students that are on the fence about getting the test is to just do it. To get the test even if they have never had a history of heart conditions before.

“It could save your life, even if you don’t believe it to be true,” Jennifer said. “Do it. Even if it is just for peace of mind.”