AUSTIN, Texas (AP) — Cody Stephens was trying to shed some of
the 290 pounds from his 6-foot-9 frame before graduating high
school and attending his first college football training camp three
summers ago when he took a nap and didn’t wake up. The autopsy
showed he had an enlarged heart, which gave out.
Spurred by the deaths of teenagers like Cody who die each year
by sudden cardiac arrest, Texas lawmakers are pushing to make their
state the first to require public high school athletes to undergo
electrocardiogram testing. Those pushing for the change, including
some of the parents of children who have died, say testing is
relatively cheap and simple, and that it could save lives.
“Kids are dying. Why not screen everybody?” said Cody’s father,
Scott Stephens, who runs a foundation with his wife that awards
grants to pay for heart screening.
But opponents of mandatory screening, including the American
College of Cardiology and American Heart Association, question its
effectiveness, saying it would lead to thousands of false-positives
each year, which would lead to further, more expensive testing that
Furthermore, they point out that relatively few children die of
sudden cardiac arrest. According to Texas officials, only nine of
the more than 13.6 million public middle school and high school
students who played sports from 2005 through 2014 died of cardiac
arrest during a game or practice. That figure doesn’t reflect Cody
Stephens’ death, because he died at home.
“Indeed, the major cause of death in young athletes, by a factor
of 10-fold, is accidents,” said Dr. Benjamin Levine, a Dallas-based
cardiologist and former vice president of the American College of
Sports Medicine, who opposes the mandatory testing proposal.
The debate over mandatory electrocardiograms, also known as ECG
or EKG tests, has been swirling for years and is rekindled with
each death of a young athlete. Despite the resistance of the
medical establishment, groups like the Stephens’ have been
sprouting up throughout the country.
Testing advocates notched a partial victory in April, when the
Texas House voted to require public high school athletes to get
tested before their first and third years of competition.
Although the state Senate has yet to decide on the measure, the
state House’s vote was significant because Texas has more high
school athletes than any other state, said Martha Lopez-Anderson,
who founded the Florida-based Saving Young Hearts foundation after
her 10-year-old son Sean collapsed and died while
“All eyes on are Texas. If it passes in Texas, other states will
follow,” she said.
Texas has tried the lead-the-country model in youth sports
health policy before, setting up a massive high school steroids
testing program in 2007. State lawmakers are poised to scrap it
this year after spending more than $10 million and catching only a
handful of cheaters.
Unlike the steroid testing program, the state wouldn’t fund the
heart screening proposal, meaning athletes and schools would
shoulder the costs.
Non-profits offer schools free or low-cost ECGs in 26 states —
some as cheap as $15 — according to the advocacy group Screen
Across America. Some, like the Go Big or Go Home Cody Stephens
Foundation, offer grants to pay for ECGS. Others, meanwhile, bring
the machines and trained personnel to the schools to conduct the
Pat Shuff of The Cypress ECG Project near Houston told state
lawmakers his organization has screened about 23,000 students over
the past two years, deeming more than 40 as “high risk” who needed
follow-up tests. He said statewide testing would identify hundreds
of others who need medical intervention.
Cardiology experts are concerned about the tests’ reliability
and the expertise of those conducting and reviewing them. The Texas
measure would require about 400,000 tests per year, and the state
only has 225 pediatric cardiology specialists.
And while an ECG can detect some conditions, such as an enlarged
heart, it can’t detect others, such as a coronary artery defect,
said Dr. Silvana Molossi, co-chair of the American College of
Cardiology Sports and Exercise Council.
ECG testing also have a false-positive rate of anywhere from 2
to 8 percent, Molossi said.
At the high end, the Texas plan could sideline 32,000 students
with false positives that send them for more expensive follow-up
procedures such as echocardiograms and magnetic resonance imaging
scans that could cost thousands of dollars.
Texas already requires student-athletes to pass a physical,
which includes a checklist of warning signs for heart trouble that
could prompt further testing such as an ECG.
Screening advocates say it’s not enough, noting that the
European Society of Cardiology and International Olympic Committee
recommend that young athletes undergo ECG screening, and that some
other countries, including Italy and Israel, mandate
Cody Stephens had two ECGs before he died — one in the seventh
grade and one in ninth grade, when he was diagnosed with
exercise-induced asthma. Neither showed heart problems, but he was
still growing, and put on 140 pounds in the three years before he
died, his father said.
Scott Stephens said an ECG before his senior year might have
saved his son.
“I don’t know that,” Stephens said. “But this is bigger than
would it have helped my son. … What I can do is keep parents from
knowing the pain my wife and I know.”