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.”

Perspective

July 9, 2018

(This blog first appeared on MHSAA.com November 2, 2010)

Each summer I put together a list of all the problems we’re addressing and all the projects we know we’ll be working on through the MHSAA during the year ahead. It’s always a long list, and accomplishing just a few items would make any year a good year.

So, this requires that we try to decide between all that we might do and all that we must do. And here’s a reminder of one thing we must do.

When I ask school and community groups with whom I’m speaking about what they think the problems are in school sports, the most popular responses from these constituents are (1) too little funding, and (2) too many misdirected parents; or sometimes that order is reversed: over-involved parents and under-funded programs.

I like to caution people that in some situations, our students suffer from too little adult engagement in their lives and that, almost everywhere, interscholastic athletics benefit greatly from the time and energy parents and other adults volunteer to help local programs operate. But I get the point of what I’m hearing.

These and other responses I hear – serious as these cited problems can be – may merely be symptoms of the single, fundamental issue that’s at the heart of all the others. That’s perspective.

  • Too little money for schools and sports?

  • Perspective – spending money on less essential things.

  • Pressure-packed parents?

  • Perspective – people focusing on adults’ desires more than students’ needs.

  • Poor sportsmanship?

  • Perspective – forgetting or never learning the pure purpose of educational athletics.

  • Too much specialization?  Too much year-round competition?

  • Perspective again.

  • Too much talk of college athletic scholarships?

  • Perspective once again.

In essence, almost all issues arise from matters of perspective. At their root, almost all problems are problems of perspective.

What can we do about this?

I don’t have the perfect prescription; but one thing is certain: we can’t relegate this to an afterthought. We cannot hope to make time to address this problem each day; we must plan to make time for it each day.

We need to model a positive perspective. Point to it when we see it. Explain it. Reward it.

It can’t be left to others. We are the guardians of proper perspective. It’s Job 1.