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.”

“How” Matters More

March 4, 2014

“It’s not whether you win or lose; it’s how you play the game.” We’ve all heard that bromide, especially when we were just starting out as young athletes.

Well, it does matter who wins. Any time a score is kept, the result of the competition matters to people. And there is very much that is very good about trying to win – giving one’s best effort to prepare for and execute a victory. Trying to win is much better than not trying to win. Sloppy effort does not benefit the participants, or anybody else for that matter.

And this unveils the deeper truth of that tiresome platitude: how you play the game is more important than who wins the game.

One of many events that proves this point to me is a football game played late in the season nearly two decades ago. A team from the east side of our state played against a team from the west side. I don’t remember the final score. I don’t remember which team won the game. But I do remember that there was an ugly incident at the end of the game. 

How that game was played in its closing moments has stayed with me for longer than who was victorious.