Proper Cardiac Screening for the Athlete
Conventional medicine pontificates about their superiority to all other healing arts (especially when it comes to making a diagnosis), yet the author of the American College of Cardiology's position statement about Cardiac screening for athletes OPPOSES the use of EKG's to screen for abnormalities. Incredible!
The argument is that there would be too many false positives and that the cost is too high. Well, let the patient make the decision regarding cost. And as for too many false positives, this is not the case if a competent cardiologist reads the EKG.
This comment is quite revealing: another reason that “he opposes EKG screening is that there is a high likelihood of disqualifying athletes whose risk is small or difficult to quantify. For athletes who have spent much of their lives preparing to play competitive sports, such a prohibition is a tragedy.”
This comment makes clear the complete lack of communication between and respect for the rest of the sports medicine and sports performance staff. These athletes do not have to be disqualified (unless there is a clear reason). They need to be closely monitored.
It all starts with a proper pre-participation physical HISTORY and exam. Yes, HISTORY!! If parents, athletes, and medical staff actually paid attention to either the American Academy of Pediatrics Pre-Participation Sports Physical form AND the Pediatric Sudden Death Cardiac Assessment form, they would quickly see reasons to pause and make an honest assessment of the athlete’s health. This, combined with a complete examination and EKG, would be quite accurate.
Once these issues are noted, the athlete must be properly monitored. This requires self responsibility, parent responsibility, coach responsibility, and medical staff responsibility. A short meeting of all these people is necessary to discuss the issue and make and agree upon a plan. This plan can be quite simple. Answer these questions daily:
Did you eat two healthy meals yesterday?
Did you sleep well last night?
How tired are you today (0 not tired – 10 exhausted)?
Are you ready to train today ((0 nope – 10 rare in the go!)?
Morning heart rate – is it more than 10 beats per minute above your normal heart rate?
Weight. Compare to day before. Did it go down more than 5%?
Monitoring during practice:
At any point in practice is the athlete struggling – breathing heavy, sweating profusely, “out of it,” not responding to commands? The athlete, coach, and medical staff must pay attention!
Take your weight and heart rate before and after practice. Any significant changes? Is your heart rate going back down or is it staying elevated for the rest of the evening? Did you lose more than 5% of your body weight? Are you re-hydrating?
There are more measurements that can be taken, but the above takes only minutes and can make a lifesaving difference.
