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 National Perspective

March 30, 2018

The Handbook of the National Federation of State High School Associations provides rationale for the following eligibility rules that are common to its member associations across the USA:

  •  Age

  •  Enrollment/Attendance

  • Maximum Participation

  • Transfer/Residency

  • Academic

  • Non-School Participation

  • Preparticipation Evaluation

  • Restitution

  • Amateur/Awards

  • Recruiting/Undue Influence

Here’s the rationale provided by the National Federation for the transfer/residency rule:

“A transfer/residency requirement: assists in the prevention of students switching schools in conjunction with the change of athletic season for athletic purposes; impairs recruitment, and reduces the opportunity for undue influence to be exerted by persons seeking to benefit from a student-athlete’s prowess.

“A transfer/residency requirement: promotes stability and harmony among member schools by maintaining the amateur standing of high school athletics; by not letting individuals other than enrolled students participate, and by upholding the principle that a student should attend the high school in the district where the student’s parent(s) guardian(s) reside.

“A transfer/residency requirement: also prohibits foreign students, other than students who are participants in an established foreign exchange program accepted for listing by the Council on Standards for International Educational Travel (CSIET), from displacing other students from athletic opportunities.”