Cardiac Screening

October 31, 2014

The American Heart Association has once again concluded that sophisticated and expensive heart screening is not practical or appropriate as a precondition for youth and young adults to participate in competitive organized sports.
On Sept. 14, 2014, the AHA online publication Circulation stated:

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.”

Future Actions

February 19, 2016

MHSAA committees have prepared not quite two dozen recommendations for Representative Council action later this spring. Once again this is a smaller than average number of proposals, and again they are modest in scope and significance. What has been different in recent years, and especially this year, is the length and depth of discussions by some of the committees.

Slowly, we are changing committee focus from tournament tweaks and other strictly transactional business to more strategic, even transformational issues.

Several committees talked longer than ever about health and safety issues, with attention to concussion and sports specialization, and how to accommodate and appeal to younger grade levels (6th, 7th and 8th).

I look forward to the day when these long discussions turn into provocative proposals. For example, I would love to hear that ...

  • The MHSAA Football and Junior High/Middle School Committees recommend MHSAA sponsorship of flag football at the 6th- through 8th-grade levels.

  • The MHSAA Soccer and Junior High/Middle School Committees recommend practice and game policies that reduce heading at the 6th- through 8th-grade levels.

  • The MHSAA Golf Committee recommends MHSAA sponsorship of coed, Ryder Cup format golf.

  • The MHSAA Tennis Committee recommends MHSAA sponsorship of coed team tennis.

There is so much more we could be doing to transform school sports for the 21st Century. New sports and formats, with increased attention to health and safety and the junior high/middle school level. This is our future, when talk turns to action.