Simple tests can detect hidden heart problems in young women that increase the risk of sudden cardiac arrest, known as sudden cardiac death (SCD), British researchers say.
The findings emerge from an analysis of a voluntary screening service funded by a bereavement charity that has been operating in the UK since the early 1990s.
Of nearly 40,000 women aged 14 to 35 who had heart screenings, 175 had undiagnosed problems despite appearing healthy and alert, and 94 of them were at high risk of sudden cardiac death.
Experts say it's not just male athletes who are at risk, but young women as well, and early diagnosis can save lives.
The UK's National Screening Committee is considering whether everyone over 14 should be screened for sickle cell disease.
Public consultations are planned, although the date has not yet been confirmed.
The challenge is to identify real cases of heart-threatening diseases and compare them with the concern caused by unnecessary screening of large numbers of young people.
Simple tests such as an electrocardiogram (ECG) can also miss some cases – this latest study of girls and women found 92 cases of heart problems, 28 of which were quite serious.
Some causes of sickle cell disease can be inherited, and the NHS offers free family screening if the condition is suspected.
«"My lips turned blue."»
Caitlin collapses during netball match [CRY]
Caitlin Lawrence, 24, from Surrey, was diagnosed with an abnormal heart rhythm two years ago after collapsing on a netball court.
She was about to play a championship match when she became ill.
«"And then, a few seconds later, I just passed out on the sideline," she says.
«"My teammates say they couldn't revive me and my lips started turning blue even though I was still breathing.".
«The next moment I was already in an ambulance, being taken to the hospital.».
«"I'm lucky I didn't die.".
She now has a device called a defibrillator implanted in her chest, which has already saved her life twice.
«"It might give me an electrical shock to get my heart working properly again," she explains.
«"When this happens, it feels like a dull thud. I had this happen just recently, in February. It's a bit scary, but it helps. I also take beta blockers to keep my heart rhythm normal.".
Caitlin says her condition could have been detected with a quick and simple electrocardiogram (ECG), which records her heart rhythm.
Her family members are now undergoing testing, and many of her friends have also decided to undergo testing.
In the UK, 12 young people under 35 die from sickle cell disease every week. The risk is approximately three times higher for boys and young men than for girls and young women.
People may not have any symptoms and may appear perfectly healthy, with no obvious warning signs.
Simple actions such as taking a cold shower or playing sport can send someone with an undiagnosed condition into cardiac shock and lead to instant death, says the charity CRY (Cardiac Risk in the Young), which offers voluntary screening.
The paper says the real toll could be even higher than previously thought, as some cases of sudden cardiac death are misreported as asthma, epilepsy or even drowning.
Postmortem examinations can reveal a structural problem or electrical fault in the heart, often hereditary. However, in one in 20 cases, the cause cannot be determined.
The latest research results, covering a decade of work by CRY, a voluntary screening programme, are being discussed at the British Cardiac Society's annual meeting in Manchester.
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The tragedy of the "invisible killer" of youth
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The teenager met with the doctors who provided first aid after the cardiac arrest.
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A family who lost a child raised thousands of dollars for a heart examination.