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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.”

Life Saving Lessons

June 24, 2015

In 2015-16, we enter the fourth quarter of a heightened eight-year health and safety emphasis. We began with Health Histories in 2009-10 and 2010-11; the second quarter focus in 2011-12 and 2012-13 was Heads; the third quarter focus in 2013-14 and 2014-15 was Heat. In 2015-16 and 2016-17, it’s Hearts that we bring in focus ... especially addressing sudden cardiac arrest which is the No. 1 cause of death to youth during exertion.
Sudden cardiac arrest seems to us to have a random, unpredictable nature; and medical experts tell us that screening is somewhat unreliable, often missing some likely candidates even as the tests identify many false positives. There are symptoms of sudden cardiac arrest, but they often reveal themselves too late to be of much help, like sudden collapse, no pulse, no breathing and loss of consciousness.
Nevertheless, there is something we can do. We can be prepared. We can develop emergency plans, display AEDs and deliver CPR. And, like any good sports teams, we need to practice our preparations.
Through the energy of the Minnesota State High School League and the generosity of Medtronic and the NFHS Foundation, the MHSAA has sent to every MHSAA member high school athletic director this month the ANYONE CAN SAVE A LIFE Emergency Action Planning Guide for After-School Practices and Events. This publication suggests a game plan that establishes four teams on every level of every sport in a school – a 911 Team, CPR Team, AED Team and Heat Stroke Team.
This resource can help schools revise or revitalize their existing emergency plans in ways that engage team members in planning, practice and execution. This could help save lives now and also convey important lifelong lifesaving lessons to students involved on these teams.