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No clear path on teen athlete cardiac screening

Editor's note: A survey of Washington state physicians finds that less than half know about American Heart Assn. student-athlete heart screening guidelines, and just 6% follow them. Adolescent collapses are dramatic and difficult to comprehend, says Art Hsieh, and the public will put pressure on schools to reduce the chances of it happening, regardless of whether screening actually does much good.

More emphasis has been placed upon identifying young athletes for the risk of cardiac arrhythmias during the past decade. Yet as this study points out, most physicians are not familiar with a 1996 set of AHA guidelines to help guide the examination process. However, it's not clear whether early identification actually makes a difference in reducing sudden cardiac death. Ergo, the issue becomes about whether something that makes sense on paper translates to measurable change in outcomes.

Here's the third view: to watch an adolescent collapse during a game and die is dramatic, emotion-laden and difficult to comprehend. The public really doesn't want this to happen in front of them, and will put pressure on its schools to reduce the chances of it happening, regardless of the science or cost. I'm not saying it's right or wrong to do so, but it certainly adds to the dynamic.

One more view: society places tremendous value of the performance of athletes. That I can't understand. Is the value of a sports star far greater than a teacher, or EMS provider? What is the contribution to the community? It can drive students and their families to push beyond the boundary of common sense in pursuit of athletic success. I've heard stories about hidden head injuries and glossed-over murmurs that student athletes try to hide in order to gain more playing time.

All of this sets up a difficult situation for all involved. I agree with one of the physicians interviewed in the article — let's establish the baseline issues first, and work toward a process that's reasonable in protecting the athlete's health.

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