SPORTS medicine expert Dr Akshai Mansingh says greater attention is needed to safeguard against heart conditions in student-athletes across the island.

The topic of heart screenings has long been an issue in local sport, especially at the secondary school level, and became a heightened cause of concern in 2016 when St George’s College Captain Dominic James died on-field of heart failure during an Inter-secondary Schools Sports Association (ISSA) Manning Cup football game.

With that incident, the awareness of the need for defibrillators (devices that apply an electric charge or current to the heart to restore a normal beat) at games heightened, and donations were made to several schools islandwide through charitable organisations such as Team Jamaica Bickles.

Concerned parents recently told the Jamaica Observer that they took their children in for heart screenings before the Manning Cup season started last month, as their respective schools had not scheduled any for their teams.

The Sunday Observer contacted ISSA about whether a policy mandating screenings is in place ahead of its competitions, but received no response.

The University of The West Indies (The UWI) recently attempted to partner with the Ministry of Sport to have a screening programme in place so as to increase accessibility for the public and local teams, but this was not realised.

“In general it’s ideal to get all school athletes screened but how practical it is, I’m not too sure,” Mansingh, dean of The UWI’s Faculty of Sport, told the Sunday Observer. “So, I guess you could say that until this happens, I don’t see it as something that will be practised widescale; it’s a pity, if that’s the case. This is a tragedy, because we do have certain regulations for various higher-level sports.”

The most popular form of heart screening done in Jamaica is an electrocardiogram (ECG) because of its accessibility and cost. An ECG records the electrical activity of your heart, including the rate and rhythm.

Mansingh says the best test is an echocardiogram, commonly referred to as an echo, which he describes as “like an ultrasound of the heart”. But this is expensive.

“The best thing to do, firstly, is to get the history — to do a screening questionnaire where you find out if the person had anything like shortness of breath when they run, any family history of heart disease, anything like that. The second part is an examination where someone will listen to the heart to see if there are any prolonged beats, or [they will listen for] anything they hear that’s wrong. These are very easily accessible, because you just need to be at any doctor and that should take care of it. Then comes investigations.

“It does rule out certain things that may be wrong with the heart but, very often in athletes, you have things which could be misleading, or it may point out something that’s wrong and is [actually] just a normal variant in any athlete. But also, it might miss a lot of stuff because an EGC can only pick up certain electrical problems of the heart, not structural problems.”

Mansingh says it is a matter of firstly educating the public on the importance of screening, then mandating that this is done by experts. He suggested Heart Foundation of Jamaica (HFJ) as a good place to get tested as he has seen unscrupulous practices among local football clubs regarding their screenings.

“I have seen where clubs will go and get someone to dishonestly sign off their players’ cardiac fitness,” he said. “It’s a fact they don’t recognise that they could be causing serious jeopardy to their players.

“When dealing with athletes, there could be results found that may be normal for an athlete but medical personnel [who are] not fully experienced in this area of medicine [could] see it as abnormal.”

HFJ has also warned of the need for teams to get heart screenings before engaging in competition, saying in 2019 it had noticed not many teams were dong so.

The Observer contacted the foundation recently about the frequency of schools visiting for tests but was told to direct questions to its marketing officer via email. There was, however, no feedback.

Mansingh said, though, that it would be impractical to expect rural schools to come into Kingston to get screenings done, for reasons such as the cost of travel.

He says if forced to choose, he would rather schools be equipped with defibrillators than ask each to do their own screenings, although he wishes there was a screening programme in all schools.

“This would be so that all the athletes could get proper screenings done promptly so that you can act upon it — not a week before the Manning and daCosta Cups,” he said. “It’s not that hard to do because it just needs organisation and resources — but saving the life of a high school athlete must be worth the expenditure.

“Ideally, you’d have both — a screening before, and a defibrillator at the game. I’m not saying screening is not important but it’s probably more important to have a defibrillator at a match because it’s what will save a life, in most cases. Cardiac screenings prevent you from getting to that stage — in most cases.”

Mansingh says a strong policy would be enforced by ISSA and the schools, but in partnership with the Government and an agency tasked to carry out the execution.