Cardiac Screening
October 31, 2014
Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”
“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”
“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”
“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”
“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”
“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”
The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”
School Sports’ Influence
June 20, 2017
As I sat a year ago in an audience consisting of my colleagues from across the U.S., I shared the general frustration – or perhaps it was exhaustion – when a veteran member of our national sports medicine advisory committee discussed the role of high school sports leaders in addressing what he said posed the greatest threat to students.
That threat was nothing we had been working on so very hard for so very long. It wasn’t heads, heat or hearts. Not extreme weight loss in wrestling or, increasingly, in other sports. Not communicable diseases, especially in wrestling. It wasn’t specialization. Not performance enhancing drugs.
He reported that the greatest threat is accidents. Away from the practice and competition venues, and especially traffic accidents. He wondered what our role should be.
He acknowledged much we’ve done regarding so many issues in the past, and all the newer issues – such as opioid addiction, depression and suicide – that are pressing for our attention; but he said it was the same issue today that it has been for decades that most threatens students. Accidents. Especially automobile accidents.
He admitted that the time and place of this threat was not under the control of athletic coaches and administrators. But his point was that the time and place is still under the influence of coaches and administrators.
Say all you want that school sports is irrelevant in this age of video games and ubiquitous non-school sports. This physician knows the score. He knows that school sports still matters mightily to kids, and that those in charge of local school sports programs still yield great power over young people.
Pick a problem – almost any problem – and people want school sports to address it. From bullying to bulimia, from obesity to overuse injuries. It is unfair to ask us to do all this, especially when funding for school sports is considered a frill in so many places.
But it’s a heck of an honor to work in an area where people think we’re the solution, or at least a deterrent. So we keep trying.