There’s a big change coming for parents of high school athletes. Starting this fall, a new law called the Second Chance Act will require all high school athletes who want to play sports during the 2026-2027 school year to pass an electrocardiogram (ECG or EKG) screening. The bill allows a student who has received an ECG in the two-years prior to the 2026-2027 school year to use that ECG scan to meet the requirement for this upcoming year. If a student has an ECG that detects a problem, they must get written medical clearance from a doctor to play sports.

Jamie Decker, M.D., a pediatric cardiologist in the Heart Institute at Johns Hopkins All Children’s Hospital in St. Petersburg, FL shared more information about this change.

What led to this new requirement?

Decker: The hope is to decrease the incidence of sudden cardiac arrest in student athletes and to detect heart problems before they have any symptoms. The Second Chance Act was inspired by Chance Gainer, a senior high school football player at Port St. Joe High School on Florida’s panhandle. Chance became unconscious during a game and later died from a previously undiagnosed heart condition. Chance’s family and a state leader pushed for the change.

Who’s impacted?

Decker: All high school students participating in a sport for the first time will need to get an ECG. This included all incoming ninth-grade student-athletes and any student in grades 10–12 who have never participated in any sports before this year. The goal is to identify undetected cardiac diseases and enhance athlete safety. We're currently doing a lot of screenings for eighth graders, who will soon be ninth graders, and are going to be participating in sports to try and get ahead of the rush before next school year.

How was the screening before this change?

Decker: The screening process that occurred up until this coming year consisted of a questionnaire that the American Heart Association published 20 years ago asking specific questions about family history, personal history, medications, etc., alongside a physical exam. Now the student athletes will be required to get an electrocardiogram or an ECG/EKG alongside that questionnaire.

What is an EKG/ECG?

Decker: It’s a quick and simple test. We attach stickers with electrodes to the chest, arms and legs. They are attached to a machine that creates an electric map of each heartbeat. The test can help diagnose irregular heartbeats and other problems of the heart that could lead to sudden cardiac arrest. It takes less than five minutes and is painless.

Aside from ECG, what else can parents keep an eye on regarding their son or daughter’s heart health?

Decker: Symptoms are important to pay attention to, particularly during activity. If a child complains of palpitations, which are fast or irregular heartbeats, or if they have chest pain or pass out while they're playing sports, that's a red flag that would require us to evaluate them.

Do you believe this will be lifesaving?

Decker: I believe that this can save lives. Data shows that adding an ECG to the physical exam and questionnaire is more likely to detect an underlying cardiac problem in a person with no symptoms. Florida is the first state to mandate this requirement, and we are excited to be on the forefront of making our children safer.

How can I get an EKG/ECG for my child?

Decker: Johns Hopkins All Children’s Hospital will soon offer low-cost options, including a $25 ECG at several of our Outpatient Care locations with a prescription from your primary care provider or walk-in availability with no prescription at our Urgent Care Services at our Tampa location. We are also working together with an organization called Who We Play For, which is offering $20 ECG scans (they also offer grant funding for families unable to pay) to anyone age 10-25. The organization is visiting schools across the state as well as community-based locations. You can check out their website for upcoming screening dates: WhoWePlayFor.org For more information about our sports cardiology program, visit Sports Cardiology at Johns Hopkins All Children's.