Support Physicals, Not Mandated Heart Tests for Student Athletes

TMA Letter by Angela A. Hilger, MD and Jason V. Terk, MD

March 24, 2015


The Honorable Jimmie Don Aycock

Texas House of Representatives
PO Box 2910
Austin, TX 78768-2910 

Dear Chairman Aycock:

We are providing comment on House Bill 767 by Rep. Wayne Smith. This legislation attempts to address a serious concern about sudden cardiac arrest (SCA) among student athletes. In the United States, an estimated 2,000 patients younger than age 25 die each year of SCA.  Often, patients have displayed no symptoms of heart disease or may have overlooked symptoms before their death. SCA can be caused by disorders affecting the structure or electrical circuitry of the heart. For young adults who have underlying cardiovascular conditions, physical activity can increase the likelihood of SCA.  

While electrocardiograms (ECGs) could enhance screening for cardiac disorders, there is a lack of scientific evidence demonstrating whether or how this should be implemented on a broad scale in the United States. The medical evidence does not support mass screening with ECGs, as required by HB 767. Currently, organizations including the American Heart Association and the American Academy of Pediatrics recommend a thorough physical exam and a medical history of the student performed by a licensed medical doctor as the most efficient method in identifying potential health issues. We urge your active support of the Sunset Advisory Commission’s recommendation that would require student athlete pre-participation physical exams to be performed by a licensed physician or delegated to an advanced nurse practitioner or physician’s assistant.

Because SCA is only one of several health concerns facing student athletes, we want to ensure students receive a full physical exam based on the most appropriate, evidence-based strategies before implementing new requirements. We want to ensure all athletes are examined appropriately before competing to decrease injuries resulting from concussion or heat illness. We respectfully request your leadership in this area by funding Texas research to examine health and safety factors affecting Texas student athletes. This includes identifying ways to better track injuries and deaths. Through this effort, we have a great opportunity to study the best way to address SCA and make improvements for our student athletes on a multitude of health outcomes.

We thank you for your passion for ensuring the health and safety of our young athletes, and we are ready to work with you on science-based solutions.

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Last Updated On

June 20, 2016

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