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.”

Close Calls

November 22, 2011

The little slip of paper I removed from the fortune cookie read:  “Every important call is a close one.”  That notion may be more critically important in some aspects of life than others, but nowhere in the fun part of life is it any truer than competitive athletics.

Where the winning margin can be a fraction of a second or inch, observed by hundreds or even thousands of spectators, athletes, coaches and contest officials, we know this to be true:  the toughest decisions are the most critical, most defining of all.

School and school sports administrators learn that it is the closest calls – where evidence is least conclusive, opinions most divided or precedent lacking – that have the greatest effect on their school communities and their own careers.

It is at these times – close calls – that leaders show up.  That they speak up.  That they stand up.