The 'invisible killer' of the young: families call for cardiac screening
Around 12 young people die in the United Kingdom each week from sudden cardiac death, most often during routine daily activities or on the sports pitch, and most often in people who had no diagnosed structural heart disease. Bereaved families are now pressing the government to adopt cardiac screening as a national health policy, bringing together rigorous health-economic calculations and the voices of grieving parents.
Cardiac Risk in the Young (CRY), a charitable organisation that has been running its campaign for three years, has gathered more than 31,000 signed petitions. CRY chief executive Dr Steven Cox told the BBC that '80 per cent of young people who lose their lives previously gave no warning signs; without screening, there is no way to make these diagnoses'. CRY is calling for ECG screening for all young people aged 14 to 35 on a non-seasonal basis.
The mortality statistics point to a small set of pathologies: 62 per cent of cases are attributed to arrhythmias of indeterminate cause, 23 per cent to hypertrophic cardiomyopathy (HCM), and 15 per cent to coronary artery anomalies. All three diagnostic categories can be screened with high accuracy by a simple ECG (electrocardiogram) test.
The acute pain comes from active sportspeople. Lily-Mae Vine, 16, died last October during a university basketball training session; the cause of death was recorded as left ventricular non-compaction cardiomyopathy (LVNC). Her mother Sarah Vine told the BBC: 'Lily showed not a single sign of fatigue in her entire life; a simple ECG could have saved her.'
The debate is multilayered. NHS England, in its 2022 pre-evaluation of a comprehensive screening programme, said the programme would cost 380 million pounds a year and that false-positive results could create a psychological burden for families. The Royal College of Physicians argues the opposite: 'in any scenario, the added diagnostic capacity reduces insurance premiums and lowers long-term cardiac service costs'.
Case studies in Europe are illuminating. In Italy, since 1982, annual ECG screening has been mandatory for all athletes aged 12 to 35; since then, cardiac deaths in sport have fallen by 89 per cent. This provides the strongest international data on the potential effectiveness of screening; however, the cost of the Italian model, scaled to the general non-athlete population, is debatable.
The matter has also been raised in the UK Parliament. North Tyneside MP Mary Glindon said in a written question to the Department of Health that 'every family should be able to expect their child to receive a simple cardiac evaluation during a physical examination'. Secretary of State for Health Wes Streeting noted in the Hansard record that 'the existing evidence is inadequate', but he also confirmed that a new Health Sciences Council evaluation has been initiated.
The cardiology community is also divided. Dr Sanjay Sharma of the Royal Brompton Hospital, in a 2025 commentary published in BMJ Open, said 'the science shows that individual screening can be done; but rolling it out as national policy is unfeasible because of the inadequate capacity of existing electrophysiologists'. Sharma calculated that the NHS would need to triple its electrophysiologist staff.
There are pockets of progress. In February, the British Heart Foundation launched a pilot 'mobile cardiac van' programme offering free ECG screening to those aged 14 to 25; in the first three months of the programme 12,400 young people were screened and 47 had previously unknown structural heart disease detected. This figure is a notable indicator of the potential effect of a national-level implementation.
The grief experienced by each family that has lost a young person is incalculable. This article is not medical advice; if your child has a family history of cardiac disease or unusual symptoms during exercise, please consult your family physician. While the national policy debate continues, individual requests for cardiac evaluation can also be made through the existing NHS system.