An ongoing discussion in this country amongst physicians, families, insurance companies, and others involves how to better prevent sudden cardiac death among young athletes. Many times these teenagers collapse suddenly and die unexpectedly on the playing or practice field. Since someone with a heart condition that would predispose them to this often has no symptoms and a normal exam, the question then is: Can we prevent these tragedies? It is possible to find these athletes before tragedy strikes with an electrocardiogram (EKG) and echocardiogram (ultrasound of the heart). One major issue is the expense and who will pay for it. These tests are not cheap and can cost more than $1000. If they are done for screening (not because there is already a problem -- dizziness with exercising, fainting with exercise, family history, etc.), insurance companies often do not cover the expense. One study estimated it would cost over a million dollars of money spent screening many athletes to prevent one episode of sudden cardiac death amongst young athletes. As much as it is easy to feel as a caring parent that this expense should be covered by insurance, remember insurance works as "shared risk" -- the more routine tests, the more expense for everyone. And with health care so expensive at this point, more of the cost of "not everyone needs that test" will fall on the people that use that care.
One intriguing new option is mCore. There was an article in the Columbus Dispatch this week discussing the issue and mCore's ability to provide cost-effective screening. I think this is an exciting option. I hope these kind of screenings allow us to prevent more episodes of Sudden Cardiac Death.