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.”

Emergency Care

September 7, 2012

As stated in our last posting, preparticipation physical examinations are imperative; but their practical limitations will not permit every heart defect to be discovered prior to participation.

So if sudden cardiac arrest is not 100 percent preventable within the modest means of school sports, the following measures represent the standard that parents would expect – reasonable or not – for the children they put in the care of those administering school sports:

    1. There should always be a staff person nearby who holds current certification in CPR.

    2. There should always be an AED nearby and in working order, and a staff person nearby who has demonstrated proficiency in its use.

    3. There should always be an emergency plan in place with which coaches and trainers are familiar because they not only were presented it, they also practiced it.

Time is of the essence when sudden cardiac arrest occurs; and these three measures combine to deliver competent care quickly.