Starting next season, the NBA will likely become the first major sports league to standardize its physical exams.
The proposed policy was created this past weekend in Houston, the site of the league's All-Star Game, where a panel of cardiologists spoke to team doctors. Sources told ESPN.com that, as a result of the cardiologists' recommendations, the league wants to mandate that the standard electrocardiograms (EKGs) be replaced with echocardiograms, which are being performed by very few NBA teams.
EKGs can detect an irregular heartbeat, while the more costly echocardiograms are ultrasounds that allow a doctor to study the size of the heart and the strength of the heart muscle.
The league's action comes in response to a flurry of heart-related incidents in the NBA this year. Minnesota Timberwolves guard Fred Hoiberg, New Jersey Nets forward Robert "Tractor" Traylor and Los Angeles Lakers draft pick Ronny Turiaf all had offseason surgery on their aortas, the main artery that carries blood away from the heart. Then, in October, Atlanta Hawks center Jason Collier died from the side effects of an enlarged heart.
NBA spokesman Tim Frank confirmed that the league has decided on a standard testing policy for players' physicals, though he would not confirm specifics.
"At the annual meeting of team doctors, a panel of independent cardiologists retained by the league gave a presentation of sudden cardiac death in athletes," Frank said. "The presentation included a cardiac screening protocol that, beginning next season, will be required of all teams. The hearts of large, elite athletes differ from so-called 'normal hearts,' and the panel felt that having a standardized protocol -- informed by the most up-to-date learning -- for examining these hearts is the best thing for the health and safety of our players."
It is not clear whether the NBA Players Association will have the right to object to the additional testing. Echocardiograms are not only more informative than EKGs but also take 30 minutes as opposed to mere seconds. Neither test is invasive.
And that might not be the only change. Two team sources told ESPN.com that the league is looking into a full battery of required tests that is already being conducted by the Celtics, Knicks and Mavericks. Such tests could take more than a full day to go through.
A number of tests were performed on Eddy Curry after he experienced an irregular heartbeat before a game last March. When the Chicago Bulls wanted to give Curry a DNA test to see whether he was genetically predisposed to a certain heart condition, the union successfully objected on the basis that the test was beyond the scope of what the two sides had agreed to.
Curry, despite being offered a $20 million annuity by the Bulls if he failed the test, never took it. After several doctors -- including a league doctor -- cleared him to play, he signed a six-year, $56 million contract with the New York Knicks.
Union spokesman Dan Wasserman said union officials were aware of the meeting to discuss further cardiac testing but have not yet talked with league officials about the scope of the plan.
While it is easy to see why teams making huge investments in these players would want all the information available to them, it's also easy to see why some players would be uncomfortable with the new level of testing.
"I think it should be freedom of choice to have it done," Knicks center Channing Frye said recently. "Because if you want it done, that means you are going to want it known, that means you are liable for it. But more guys will say, 'I just don't want to know,' and I understand why they say that. More guys have heart problems than what they lead on. If they find out, how are you going to put food on your table, not only for you, but for your family, your uncles, your aunts, your grandma?"
Returning to play after being diagnosed with a heart-related issue could be a challenge. Curry has seen plenty of time -- and without any issues, he says. But Los Angeles Clippers backup center Zeljko Rebraca, who had surgery to correct an irregular heartbeat in November, played in only his 14th game of the season on Tuesday. Turiaf has played only nine total minutes since his offseason surgery, while Hoiberg is still weighing whether he wants to try to become the first player in the league to play with a pacemaker.
Hoiberg had two echocardiograms with the first two teams he played with -- the Bulls and the Indiana Pacers -- but during his two years with the Minnesota Timberwolves he never had an echocardiogram. His heart problem was discovered when he had an echocardiogram done in order to purchase a greater life insurance policy.
Turiaf's condition was discovered during an exam by the Lakers, who are currently among a select group of teams -- including the Boston Celtics and Dallas Mavericks -- that give echocardiograms to all of their players.
Collier reportedly had three physicals with the Hawks in the last year of his life, and all of them included EKGs. At least one of those EKGs showed "some indication of electrical abnormalities," according to Georgia's chief medical examiner Dr. Kris Perry, and should have led to additional testing. Collier's wife Katie said that her husband was never informed that there was anything wrong with him.
Although echocardiograms are not standard in any other major sports league, Dr. Elliott Pellman, medical liaison to both Major League Baseball and the National Football League, said that abnormal EKGs are typically followed up with echocardiograms.
Darren Rovell is a senior writer for ESPN.com. He can be reached at Darren.firstname.lastname@example.org.