Logo

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.”

A Solutions Approach

July 13, 2015

I had not been to New Orleans since Hurricane Katrina devastated the city, and I expected to see much change since my several visits before the flooding. What I discovered when I attended national meetings there recently was little change ... including most of the same sights, sounds and smells of years before. I expected the same of the national meetings ... “same-ol’ same-ol’.”
It has become tradition that the executive directors of the 50 statewide high school athletic associations meet twice during the annual summer meeting of the National Federation of State High School Associations in sessions separate from all other delegates to that large convention. It has also been customary for me to leave those sessions depressed as problem was heaped upon problem by the directors, with little attention to solutions.
However, between the two sessions this year, a small group of the executive directors talked about strategies to redirect the conversation; and the result of the second session in New Orleans was to develop a strategy for identifying and prioritizing the most significant problems of school-based sports, and then identifying and prioritizing the resources and alliances currently available, as well as those that could be developed through cooperative effort and strategic partnerships, to attack the most pressing problems.
The expertise to solve such problems has been in our room for years. What has been lacking is the commitment to a process that could move us from a group accomplished in citing problems and suggesting reasons for them to a group accomplished in working together to solve the most significant problems.
So, the “Big Easy” is and may remain pretty much as it always has been. But maybe future meetings of the National Federation, wherever they may be, will be undergoing substantive change.