Diagnosis empowers athletes and their athletic trainers, coaches, and parents to make important decisions to effectively manage their health, whether that means undergoing further evaluation or surgery to fix a defect, coming to terms with physical limitations, or being aware of a condition that may carry risk months, years, or even decades down the road.

Pre-participation physical evaluations are not enough to protect student athletes. Many kids do not know their family history or parents themselves may be unaware they have a condition they have passed down. In the majority of cases, there are no warning signs prior to a cardiac event. Symptoms are oftentimes unrecognizable to a student athlete or he/she may not report them out of fear of being pulled. Administering diagnostic tests is the best way to safeguard against tragedy.

Our comprehensive testing program includes cardiac testing—both EKGs and echocardiograms—to detect asymptomatic heart abnormalities that can lead to sudden cardiac death and vascular ultrasound to identify vascular conditions common to athletes, such as blood clots. All tests are non-invasive and involve no radiation exposure.

Electrocardiogram (EKG) – measures the electrical activity of the heart

  • Detects electrical abnormalities, such as Wolff-Parkinson-White, Long QT, and Brugada syndromes
  • Cappo Health applies the Seattle criteria when reading EKGs to reduce false positive reporting to less than 5%

Echocardiogram (Echo) – uses sound waves to create a moving picture of the heart

  • Identifies functional and structural abnormalities that cannot be detected by an EKG, such as congenital coronary artery anomalies, heart valve abnormalities, holes in the heart muscle, weakened heart muscle, and abnormal pressures within the heart chambers and lungs
  • Cappo Health’s echocardiography testing routinely confirms or refutes a diagnosis from an EKG

Vascular Ultrasound – uses imaging to see how blood moves through arteries and veins, evaluating for any blood flow abnormalities

  • Detects blood clots before they break free and travel to the lungs, which is called a pulmonary embolism, a potentially deadly condition
  • Assesses for abnormal flow dynamics in extremity and abdominal vessels to which athletes are prone

Apprehension to evaluating large populations of young athletes for undiagnosed cardiovascular abnormalities is understandable. But not doing so could prove tragic.

A documented issue with EKGs, and a major reason wide scale EKGs have been opposed by the American Heart Association and American College of Cardiology, is the high percentage of false positives—a valid concern. With false positives as high as twenty percent, seemingly healthy student athletes are being told they can no longer play the sports they love until they undergo more extensive evaluation.

Over the past few years, a better understanding of the physiological and anatomical differences in athletes’ hearts have led to the development of a collection of criteria. By applying the Seattle criteria to the reading of EKGs in the athletes tested by Cappo Health Partners, we are able to reduce the false positive rate to less than five percent. Our echocardiography testing routinely confirms the true positive findings of our EKGs and refutes those that are false positive.

There are serious cardiac abnormalities that can be detected through an echocardiogram, but not through an EKG, and vice versa. Hypertrophic cardiomyopathy is likely to generate an abnormal EKG, but is almost definitely detected with an echocardiogram. The second most common cause of sudden cardiac death in young athletes, congenital coronary artery anomalies, cannot be detected through EKG, but can with echocardiography. Electrical abnormalities, including Wolff-Parkinson-White, Long QT, and Brugada syndromes are identified only through EKG. The bottom line is that the two tests are complementary, and Cappo Health administers both when evaluating student athletes.

Completing the puzzle with vascular ultrasound

Heart issues are not the only area of concern when it comes to student athletes. Blood clots are something most do not think affect healthy athletes but, in fact, risk factors common to athletes, such as dehydration, trauma, and long travel, make them more susceptible to blood clots, which can be a real danger if left untreated. Clots can break loose and travel to a player’s lung, causing a life-threatening pulmonary embolism. Cappo Health is the only company with an all-encompassing cardiovascular testing program to help ensure student athletes are healthy and safe before they take the field, track, or court.

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