A new Florida Law was signed by Governor Ron DeSantis on June 25, 2025, called the “Second Chance Act”. This law mandates an electrocardiogram, or an ECG, to be added in addition to the standard history and physical exam screening prior to being able to participate in high school athletics, taking effect in August of the 2026-27 school year. But what does this mean for next year?
An electrocardiogram (ECG) is a test that measures the electrical activity of the heart. This test helps detect and diagnose various heart conditions that may cause sudden cardiac death, which occurs roughly in 1-2 per 100,000 high school athlete-years. The purpose of screening is to detect these diseases which often have no symptoms before they cause sudden cardiac death during sports participation. But how does it work? It is very simple. The patient lies on a table, and electrodes are placed on the chest, arms and legs. These electrodes detect the electrical signals from the heart. Through this test, the signals are amplified and recorded on a computer. The ECG can detect irregular heart rhythms (arrhythmias), diseases that may result in irregular rhythms during exercise, heart muscle disease, such as hypertrophic cardiomyopathy, where the heart muscle becomes too thick (one of the leading causes of sudden death in athletes), and structural heart diseases, such as heart valve or coronary artery abnormalities.
There are a lot of questions families have about the details of this law. Doctor Jamie Decker, a Cardiologist at John Hopkins All Children’s Hospital, can clarify the complexities and features of electrocardiograms. A common speculation is that to get an electrocardiogram done, they have to be done at a hospital. But, according to Doctor Decker, “families do not necessarily have to do the screenings at the hospital, we [Johns Hopkins All Children’s Hospital] partner with a non-profit organization called Who We Play For, that will come to schools and perform the screenings. They also perform these screenings at various community events.” Doctor Decker is on the medical advisory board for this organization and is part of the team that reads the EKGs.
Another common question is how much the electrocardiograms cost. Doctor Decker says, “the law says they should cost no more than fifty dollars, but we [John Hopkins All Children’s Hospital] and Who We Play For are trying to do them for roughly twenty dollars.” But wait, what if some families are not able to pay this and still want to play high school sports? As stated by Doctor Decker, “if kids can’t afford to do them, we will do them anyway.” When Who We Play For does the screening, they ask for donations, but those are completely voluntary.
However, since these screenings need to be read by professionals, the results do not come back immediately. This means kids who wait until the last minute to try and get the screenings done will not get them in time, as they will need to wait on the results for a minimum of a day. “Part of challenge is getting them read fast and accurately so they can get cleared as soon as possible,” says Doctor Decker. The first step is to ensure opportunities for students to get the ECG done, either at their school through mass screenings, their primary care doctor, or various community events, such as local sports organizations. These screening dates will be announced once they are set up.
It is also important to get this done because some of the ECGs may be abnormal and require follow up with a cardiologist. John Hopkins All Children’s Hospital is building a process to be able to see students with abnormal ECGs in a very timely manner to perform any other testing in order to make sure it is safe for students to return to sports.
Many do not know the purpose behind the name of this law. The “Second Chance Act” was given its name due to a tragic loss. On September 6th, 2024, Chance Gainer, an 18-year-old wide receiver and defensive back at Liberty County High School collapsed during the game. Gainer passed away that night, from an undiagnosed heart disease. The law was put into place to try to prevent anything like Gainer’s heartbreaking story again, and to catch any heart problems or diseases early before they become fatal.
