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Texas House Advances Bill Mandating EKGs for High School Athletes

The Texas House of Representatives approved a bill last week that would require high school athletes to undergo an electrocardiogram, or an EKG, before participating on a sports team.

The bill, which passed the House on an 82-62 vote on April 14, would require all high school student-athletes at University Interscholastic League schools to have an EKG before the student's first year of participation in sports, and again before his or her third year. If a parent or guardian submits a written request to waive the requirement, however, a student-athlete would not be required to undergo the EKG.

According to a 2011 study published in the journal Circulation, sudden cardiac arrest was the leading cause of death during exercise in NCAA student-athletes, and similar data has held true for younger athletes, too. State Rep. Sylvester Turner, one of the bill's joint authors, believes mandating EKGs could help prevent some instances of sudden cardiac arrest by uncovering undiagnosed conditions.

"These deaths are preventable and we have the resources to inform Texas parents if their child is at risk," said Turner in a statement. "The legislation does not require parents to take any medical action in response to an ECG. Regardless of the information the ECG provides, any medical decisions regarding the student athlete remain at the parent's discretion."

The legislation was inspired in part by Scott Stephens, who lost his son Cody to sudden cardiac arrest in May 2012. Since that time, Stephens started the Cody Stephens Go Big or Go Home Memorial Foundation, which helped screen over 15,000 athletes last year, according to The Dallas Morning News. Fifteen of those youth-athletes wound up needing heart surgery, and two were told to quit contact sports, the paper reported.

"We found 17 kids out of 15,000," Stephens told the paper. "If there's a million kids in the state of Texas getting a physical, that tells me—just by the math—that there's 1,000 kids out there that are possible candidates for sudden cardiac arrest."

If signed into law, the Texas bill would go into effect beginning with the 2016-17 school year. It has since been sent to the Senate for further discussion.

Sudden cardiac arrest has been a hot topic in youth-athlete safety for years. In 2011, a 16-year-old Michigan high school basketball player named Wes Leonard collapsed on the court after hitting a buzzer-beating shot due to an enlarged heart. After being rushed to the hospital and undergoing CPR, he was pronounced dead due to sudden cardiac arrest. His friends and family later created The Wes Leonard Heart Team to advocate for student-athlete-safety legislation, including a requirement that all public and private schools have enough automatic electronic defibrillators on site.

That same year, the National Athletic Trainers' Association released a statement urging states to pass pending youth-athlete-safety legislation, despite any potential budgetary concerns. At its third annual Youth Sports Safety Summit in December 2011, association members discussed ways to prevent sudden death in youth sports.

"We believe that 90 to 95 percent of the deaths that happen in youth sports are preventable," said Dr. Douglas Casa, the chief operating officer of the Korey Stringer Institute at the University of Connecticut, during that year's summit.

In November 2011, a survey presented at the American Heart Association's scientific sessions revealed that fewer than 6 percent of doctors in the state followed national sudden-cardiac-death screening guidelines to their fullest extent when examining high school athletes. Not a single athletic director said that his or her school required doctors to comply with all state guidelines at the time, either.

In the spring of 2012, meanwhile, then-Pa. Gov. Tom Corbett signed a law designed to protect student-athletes from heart failure. It required schools to issue an information sheet to parents of student-athletes about the warning signs and symptoms of sudden cardiac arrest, which they needed to sign and return to the school before their children were allowed to participate in athletics.

This past March, Dr. Brian Hainline, the NCAA's first chief medical officer, divulged to The Wall Street Journal his plan to recommend "that athletes at higher risk of cardiac death, including male basketball players, be required to undergo an EKG test to search for cardiac defects," according to the paper. However, "some 100 university team physicians" signed a petition "calling on him to change his mind," the WSJ reported one month later, which he wound up doing.

"I have become convinced that the infrastructure and knowledge base will not support this effort at present," Hainline announced at a conference in mid-April, per the paper.

The issue clearly remains contentious among medical experts, and the Texas House had its fair share of members opposed to the bill, too. We'll see over the coming weeks whether Texas state senators express the same concerns.

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