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.”

The Problem with Exceptions

November 22, 2011

Picking up where my last blog left off, this posting presents two more of six lessons that experience has taught me during my enriching years with the MHSAA.

Lesson No. 2:  Beware of bad precedent.

An exception today that doesn’t seem to matter much is almost certain to be recalled and used against you tomorrow when it really does matter. People have poor memories for most things, but they have long memories for exceptional things, like making an exception to a rule.

A corollary to this lesson is that “no good deed goes unpunished.”

Lesson No. 2 is closely related to Lesson No. 3:  The path of least resistance usually is not.

Making an exception for a squeaky wheel will likely lead to more noise, not less.

One corollary to this lesson is that there will be more fallout when people believe you have ignored rules than when people believe you have been heartless in applying the rules as stated.

A second corollary to this is that following the rules is the safest harbor during stormy seas.