Cardiac screening findings and referral patterns in male African-American basketball players: Analysis of the HeartBytes Registry

Abstract

Sudden cardiac death (SCD) is the leading medical cause of death in young athletes. Male African American basketball players (MABP) demonstrate particularly elevated risk for SCD. Despite increasing screening and preventative efforts, the incidence of SCD remains elevated in this population. This retrospective analysis of the HeartBytes National Youth Cardiac Registry (2015-2023) aimed to characterize cardiac screening findings, including symptoms, family history, physical exam, and electrocardiogram (ECG) abnormalities in MABP compared to other youth athletes undergoing cardiac screening. We secondarily examined referral patterns based on screening results between the two groups. Of 8,303 individuals screened, 200 MABP were identified. MABP were found to have higher rates of chest pain during exercise (10.0% vs. 4.8%, p<0.001), easily tiring with exercise (13.0% vs. 7.0%, p=0.003), and heart murmurs (8.9% vs. 4.4%, p=0.008) when compared to the rest of the population screened. ECG abnormalities, including T-wave inversions (4.0% vs. 0.8%, p<0.001), ST-segment depressions (0.5% vs. 0.05%, p=0.01), and nonspecific ST-T wave changes (2.0% vs. 0.4%, p<0.001), were more prevalent in MABP. However, positive screening rates leading to referral to a cardiologist were similar (3.5% vs. 3.2%, p=0.842) in MABP and the rest of the screened population. In conclusion, MABP exhibited higher rates of concerning cardiac screening findings compared to non-MABP, including symptoms, physical examination findings, and ECG abnormalities, highlighting the need for further investigation into optimizing screening strategies and determining appropriate follow-up in this high-risk group.