Cardiac Screening
October 31, 2014
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 Hot Topic
July 10, 2012
It is a terrible irony that Georgia saw two of its high school football players die late last summer when it’s the Georgia High School Association that was providing us with the best information we’ve ever had about the risks of heat illness and death.
The deaths occurred in the third year of a thorough three-year study in Georgia that is reinforcing common sense. The study is confirming who is most at risk and when they’re most at risk.
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Who is most at risk? Linemen more than other players; underclassmen more than older players; those who have had the flu or similar sickness more than others.
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When are they most at risk? During the season’s first week more than the second. During the second practice of a double session day more than the first. During the second half of the second practice more than the first half, and, early in the morning when humidity is often highest.
It all makes perfect sense: the chubby 9th or 10th grader during the second half of the second practice during the first week of the season. And because it’s statistically predictable, heat illness is almost entirely preventable.
There is some danger here in over-generalizing and over-simplifying, but awareness of these tendencies will help coaches to schedule and administrators to legislate around high-risk scenarios. We expect both will be happening in Michigan.