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.”

Simons Says

December 12, 2014

As an almost inveterate traveler – one who begins planning his next adventure to sweeten the sadness during the return trip of the current adventure – I took special note of and pleasure in this statement of Eric Simons in his book Darwin Slept Here:
“Optimism may be one of the biggest benefits of travel. When you spend all your time in a small area, trekking back and forth to work, getting all your news on the Internet, it’s easy to think the world is a lot worse off than it is. Then you get out in it, even for a short bit, and you get a summit view or find a friendly person who cares about nature just like you do, and then even when you go home, you remember: Hey, it’s not all bad. We’re really doing ok.”
When I see advertisements that promote travel as an escape, I cannot agree. For me, travel is a change from the daily routine, but it’s hardly an escape. In fact, I see more sights, hear more sounds, smell more scents and taste more flavors when I travel. I interact with countless more people – in airports, markets, parks, museums. But even moments of isolation – perhaps on a remote beach or trail – are somehow richer, more contemplative, when traveling.
It is not escape but engagement with new cultures and customs that travel causes; and it creates opportunities for personal reflection that routine obscures.
As Simons says, “Traveling connects us to the world and renews our capacity to wonder.”