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.”

Tending a Small Garden

June 12, 2015

I offer this posting as an important qualifier to my previous posting.

Year after year I expanded the borders of my garden. And year after year the overall quality of the garden declined.

I didn't notice at first. I failed to see as I introduced new plants that some of the older plants were struggling, or that other plants were growing without shape or direction. I didn't see that some weeds were taking hold in the original space that was receiving less of my attention than the newer space.

I am unable to miss this metaphor for school sports.

When we try to grow interscholastic athletics too large, we risk becoming incapable of maintaining the essential beauty and purity of educational athletics. Certain programs grow out of control, other programs weaken. Influences are introduced, some of which can be aggressive enough to take over the whole enterprise.

Let international, professional, major college and even youth sports grow out of control. Ours is and must continue to be a small garden, tended closely and carefully.