Heart defects that can cause otherwise healthy athletes to die while playing basketball or football were detected in Harvard University athletes using a common $88 test.

The test, known as electrocardiography or ECG, was given to 510 Harvard athletes in addition to their standard physicals, according to a study published Monday by the Annals of Internal Medicine. The added test identified two players who had been deemed healthy in typical examinations despite having dangerous defects that should bar them from competition. Scientists in three articles debated the merits of routine ECG tests for athletes.

Genetic heart defects caused the courtside deaths of Hank Gathers, an All-America 23-year-old basketball forward at Loyola Marymount University in Los Angeles, and Reggie Lewis, a 27-year-old All-Star guard for the Boston Celtics of the NBA. Such defects are the top cause of sudden death in sports, killing 1 of every 220,000 young athletes each year, according to previous studies.

"Screening limited to medical history and physical examination fails to identify a significant percentage of athletes with increased risk," wrote authors led by Aaron Baggish, a cardiology researcher and clinical instructor at Harvard Medical School and Massachusetts General Hospital in Boston. Still, he said, "our results may not end the complicated debate."

The biggest drawback to the test was the number of young athletes who were incorrectly identified as having a risk, the Harvard researchers said. The rate of so-called false positives tripled to 17 percent for ECG-tested patients, compared with 5.5 percent under normal screening.

False readings require expensive follow-up tests and "would unavoidably promote inappropriate disqualifications, unnecessary anxiety, and possibly chaos in a national program," said Barry Maron, director of the Hypertrophic Cardiomyopathy Center of the Minneapolis Heart Institute Foundation, in an editorial published with the study.

The deaths of Gathers and Lewis were blamed on a detectable heart defect, prompting some doctors to call for expanded testing. The defect, hypertrophic cardiomyopathy, is the most common cause of sudden fatalities in young athletes, according to a study last year in the journal Circulation.

Cardiomyopathy causes some areas of the heart to harden, forcing muscles to work harder and sometimes causing dangerous rhythms, according to the National Institutes of Health. The risk from such hardening often goes undiagnosed until someone faints or dies during exercise.

In an ECG, 10 electrodes are attached with sticky circles to a patient's arms, legs and chest. The electrodes monitor pulses of electricity that flash through a beating heart as the muscles constrict and pump blood. The readings detect unusual patterns that may indicate a birth defect or diseased heart.

The American Heart Association doesn't endorse mandatory sports testing with ECG, though some colleges have begun screening on their own, according to Monday's report. Italy adopted mandatory ECG testing in the 1980s, a policy that has reduced sudden deaths by almost 90 percent, according to previous studies.

Looking for more from the Post-Gazette? Join PG+, our members-only web site. You'll get exclusive sports content, opinion, financial information, discounts from retailers and restaurants, and more. Our introduction to PG+ gives you all the details.