John J. Ryan: 'Furthermore, commotio cordis, a cause of sudden cardiac arrest where a blow to the chest during a vulnerable phase of the cardiac cycle can trigger an arrhythmia, can never be excluded by screening.'
Buffalo Bills' Damar Hamlin is attended to after suffering a medical episode during the first half of an NFL football game against the Cincinnati Bengals, Monday, Jan. 2, 2023, in Cincinnati.The collapse of NFL player Damar Hamlin during Monday’s game highlights the perils associated with pre-participation screening in sports.
Cardiac screening programs are well-intentioned. They involve a variety of tests evaluating for pre-existing cardiac conditions, such as heart rhythm abnormalities, structural heart disease or genetic cause of sudden cardiac death. However, they require a lot of expensive resources — development of protocols, getting a team of physicians and athletic trainers together, performing and interpreting electrocardiograms and sometimes echocardiograms.
Among NCAA college athletes, only about a third of conditions that cause cardiac arrest can be detected using EKG and echocardiogram. Therefore, a negative work-up in an asymptomatic athlete as part of a pre-participation screening can give a false sense of security. For example, unless the athlete has symptoms which trigger a more in-depth evaluation, coronary artery disease can be missed with EKG and echocardiogram.
Many states required CPR certification to graduate from high school. CPR training is offered through many avenues, such as club sports teams, church socials, work wellness programs. I once taught CPR to stylists in a hair salon. It is easy to learn, do and teach. In fact, most CPR that is learned ends up being used on family members, or people living within the same household. More than anything, even aside from sports, we should want to learn CPR so we can help those closest to us.
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