Preparticipation cardiovascular screening among National Collegiate Athletic Association Division I Institutions
Coris EE, Sahebzamani F, Curtis A, Jennings J, Walz SM, Nugent D, Reese E, Zwygart KK, Konin JG, Pescasio M, Drezner JA. Br J Sports Med.2013 Feb;47(3):182-4. http://www.ncbi.nlm.nih.gov/pubmed/22976912
Sudden cardiac death has recently received considerable attention; however, experts and governing bodies are unable to agree on a unanimous screening protocol. At the center of the debate is whether we should incorporate electrocardiography (EKG) into preparticipation physicals (PPEs). While this debate lingers in remains unclear how sports medicine programs in NCAA Division 1 athletic programs are incorporating non-invasive cardiovascular screening (NICS) into PPEs. Therefore, Coris and colleagues sent out a survey to head athletic trainers of all NCAA Division 1 football programs and evaluated their use of routine NICS in NCAA PPEs. Among the 116 Division 1 programs, 74 (64%) head athletic trainers responded. Thirty-five (47%) head athletic trainers reported that they were already incorporating NICS in their PPE. More specifically, 31 of the 35 (91%) programs utilized routine EKG in PPE’s, while 17 (49%) programs relied on echocardiogram for evaluation of their athletes. This study also revealed that 22 (64%) of the participating programs use NICS only on incoming freshmen. Finally, 16 out of 38 (42%) programs that reported they do not engage in routine NICS screening suggested that cost is the main reason for not performing the screening regularly, while 13 (34%) stated that the AHA 2007 guidelines do not recommend routine NICS during PPE’s.
This non-uniform adoption of NICS reflects the current debate surrounding screening for sudden cardiac death risk in the athletic population. Professional athletic organizations (MLB, NFL, NHL, and NBA) have implemented mandatory screening, while at the college and high school level it is left to the discretion of the individual schools to implement such programs. Further, the AHA does not support NICS on a routine basis. This study most certainly addressed some of the barriers to NICS at the college level and cost issues were identified as the leading cause for not participating in routine NICS during PPE’s. It remains unclear if the actual number of programs not performing sudden cardiac death screening is higher, if all schools (e.g., Division 2 or 3), not only high profile collegiate programs were included? An interesting point was revealed in this study, that 64% of programs only screen incoming freshmen with NICS. Could this be a feasible alternative to provide broad screening and eliminate the obstacles of costs in the screening process? Do you conduct non-invasive cardiovascular screening in your PPEs? If so, how often does an athlete get screened?
Written by: Christian Glaser, DO and Marc I. Harwood, MD
Reviewed by: Jeffrey Driban
Reviewed by: Jeffrey Driban
Related Posts:Coris EE, Sahebzamani F, Curtis A, Jennings J, Walz SM, Nugent D, Reese E, Zwygart KK, Konin JG, Pescasio M, & Drezner JA (2013). Preparticipation cardiovascular screening among National Collegiate Athletic Association Division I Institutions. British Journal of Sports Medicine, 47 (3), 182-4 PMID: 22976912