Petition number: P-05-870

Petition title: Let’s Get Every Young Heart Screened (Age 10-35)

Text of petition: We call on the National Assembly for Wales to ask the Welsh Government to roll out a heart screening to all young people between 10 and 35 in Wales. Hundreds die each year in Wales from an undiagnosed heart condition and a simple ECG will identify most cardiac abnormalities so that conditions can be managed effectively.

Additional information:

Heart screening sessions involve a short 5-10-minute test which is quick and painless and able to detect most heart abnormalities and could save hundreds of lives in Wales. In the Veneto region of Italy, where heart screening programme has been undertaken for 25 years the number of young athletes, male and female, dying of sudden cardiac arrest fell from one in 28,000 each year to one in 250,000, according to a 2006 study published in the Journal of the American Medical Association.

Background

The charity Cardiac Risk in the Young’s (CRY) website states that every week in the UK at least 12 young people die of undiagnosed heart conditions and in 80 per cent of cases of young sudden cardiac death (YSCD) there are no prior symptoms of a heart defect. It goes on to say that the frequency of YSCD can be ‘dramatically reduced’ by making heart screening available to all young people between the ages of 14 and 35. The aim of a screening programme is to detect an underlying cardiac condition. Conditions which if undetected can lead to sudden cardiac death are listed on the CRY website.

CRY has carried out sessions across Wales testing young people for previously undiagnosed heart conditions. The Welsh Hearts charity also offers heart screening sessions for everyone aged 8 to 45. The Welsh Hearts website states that private heart screenings can cost around £300 per person but due to donations from Welsh Hearts’ supporters, individuals will only pay £65 for its screenings (as at March 2019).

The Welsh Hearts website explains why the screening it offers is limited to 8 to 45 year olds. 8 is the minimum age as the heart is still developing at this age and it is important to ensure an accurate reading is produced. The over-45’s age group is most vulnerable to heart conditions that can cause a cardiac arrest and these conditions can be picked up by the screening. However, people over the age of 45 are more likely to suffer from conditions which cannot be detected by a heart screening, such as a heart attack. This means that a heart screening could come back completely normal for some heart conditions, but it unfortunately cannot rule out the possibility of a heart attack.

The Welsh Government published its Heart Conditions Delivery Plan in January 2017. The Cabinet Secretary for Health, Well-being and Sport made a statement on the Delivery Plan in Plenary on 7 February 2017. The issue of developing appropriate population-level screening for certain heart conditions was raised in response to this statement and at that point in time, the Cabinet Secretary was not aware of a sensible approach to population screening in this particular area.

Correspondence on the petition

In correspondence to the Committee dated 6 March 2019, the Minister for Health and Social Services states the following in relation to the petition:

Population screening programmes generally can save lives through early risk identification but can also do harm by identifying risk factors that would never otherwise develop into a serious condition or complication. Screening programmes may have false negative results, so do not guarantee protection. Receiving a low risk result does not prevent the person from developing the condition at a later date. Population screening programmes should only be offered where there is robust, high-quality evidence that screening will do more good than harm.

The UK National Screening Committee (UKNSC) advises Ministers in the four UK countries about all aspects of population screening, and screening to prevent Sudden Cardiac Death (SCD) in 12 to 39 year olds has been considered by the UKNSC and is not recommended. The UKNSC concluded the harms of screening for SCD currently outweigh the benefits. Further information on this conclusion is set out in the Minister’s letter, along with a link to the UKNSC review and recommendation.

The Welsh Government has said it will continue to monitor developments in this area of public health and if further evidence suggests screening is beneficial it will be given the appropriate consideration.

The Minister also states that although whole-population screening is not beneficial, families of individuals with SCD should be offered individual clinical assessments to assess their risk. This is ‘cascade’ casefinding in a higher-risk population rather than whole-population asymptomatic screening.

Every effort is made to ensure that the information contained in this briefing is correct at the time of publication. Readers should be aware that these briefings are not necessarily updated or otherwise amended to reflect subsequent changes.