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      Examining sports physicals in wake of player's death

      A test that could possibly have detected the congenital heart problem that led to the death of a Hartsville High School football player Friday night, would have cost more than a thousand dollars, a high cost for families participating in school sports.

      Ronald Rouse, a senior on the Hartsville Red Foxes, collapsed on the field and was pronounced dead at the hospital of a congenital heart defect.

      By state law, all high school athletes must pass a physical exam before they can participate in a sport like football. Those exams don't include tests that may have caught Rouse's condition, which is rare among young athletes, according to Dr. Ray Holt with McLeod Family Medicine Seacoast.

      "The incidence of sudden cardiac death in athletes is one in 200,000 per year," said Dr. Holt, "So, it is pretty low."

      The screening process for student athletes begins with a health questionnaire each athlete must fill out.

      Asking each student about his or her personal and family history helps find those who may have a problem, says Dr. Ron Reynolds, with Beach Urgent Care.

      "You're looking for things like, has the child had palpitations, have they got short of breath when they've exercised, have they had chest pain when they exercise, have they ever passed out with exercising?"

      The next step is a physical exam.

      Among other things, the doctor will listen for a heart murmur, especially one that may be louder than normal or change with body position.

      "This murmur actually decreases when we have the child squat down, "said Dr. Ray. "If we hear that, that leads us down that road."

      If a heart problem is suspected through questioning or a physical exam, the doctor may prescribe further testing, usually an EKG and an echocardiogram.

      But an EKG can cost $1,000, an echocardiogram even more.

      Doctors say, doing a test like that on every athlete, just to find the rare few who might have a defect, would simply cost too much.

      "Unfortunately," Dr. Ray said, "unless all of these very, very expensive tests are done to everybody, you can't catch every single one."

      Dr. Holt from Seacoast agrees, saying current physical exams aren't perfect, but they're the best we have now, and the most important thing is to make sure every athlete gets that physical before taking the field.

      Doctors say about 40% of sudden cardiac deaths in athletes are because of an enlarged heart. ã??