Starting with the 2026-2027 school year, Florida’s Second Chance Act will require many high school student-athletes to complete a one-time electrocardiogram, or EKG, before participating in sports governed by the Florida High School Athletic Association (FHSAA). The new requirement is intended to help detect hidden heart conditions that may increase a young athlete’s risk for sudden cardiac arrest.
For families, the requirement may feel like one more step in the sports physical process. For pediatric heart specialists, however, it represents an important opportunity to identify potential concerns before a child or teen takes part in competitive athletics.
Sudden cardiac arrest is the leading cause of sudden death among young athletes. In many cases, there are no advance signs or symptoms, which means a young person may appear healthy until a serious cardiac event occurs during sports or other strenuous activity.
An EKG is a simple, noninvasive test that records the heart’s electrical activity. It can help identify certain rhythm abnormalities or other findings that may require closer review by a pediatric heart specialist. The test itself is simple and usually takes only a few minutes. Small stickers are placed on the chest, and sometimes on the arms or legs, to record the heart’s electrical signals. The screening does not involve needles or radiation, and the student does not need to exercise during the test.
“Most young athletes who need an EKG screening feel healthy and have no known heart problem,” says Danyal Khan, M.D., pediatric cardiologist with the Nicklaus Children’s Hospital Heart Institute. “That is exactly why screening matters. An EKG gives us another way to look for signs of a possible hidden heart condition before a child is placed under the physical demands of competitive sports.”
Under Florida’s Second Chance Act, high school students participating in sports governed by the FHSAA must complete a one-time EKG screening. Families should confirm the specific requirements with their school or athletic department before the start of the sports season.
An abnormal EKG result does not automatically mean a student-athlete has a serious heart condition or will be unable to play sports. It means the child may need further review by a qualified healthcare professional to determine whether additional testing is needed.
In some cases, follow-up evaluation can rule out a serious concern and provide reassurance for families. In others, early diagnosis can help guide treatment or activity recommendations that may reduce the risk of a life-threatening event.
“The goal is not to scare families or keep children from playing sports,” Dr. Khan says. “The goal is to make sports safer by identifying young athletes who may benefit from additional evaluation. When we find a concern early, we have more options to help protect that child.”
Nicklaus Children’s has offered EKG screenings at no cost for children and adolescents ages 5 to 21 since 2011. Individual screenings are available at multiple locations throughout South Florida, and screening events can also be coordinated with schools and community organizations.
Families should also talk with a medical professional if their child has symptoms such as chest pain or fainting during activity. A family history of sudden cardiac death or inherited heart disease is another important reason to seek medical guidance.
The new Florida requirement is an important reminder that heart health is part of sports safety. With greater awareness and access to pediatric heart expertise, families can take an added step to help protect the young athletes they know and love.
To learn more or schedule an EKG screening, visit nicklauschildrens.org/EKG or call 855-624-3547. To coordinate a community screening event, email SCDPProgram@nicklaushealth.org.