Even in youth, high-intensity exercise can cause sudden death or cardiac arrest if certain rare congenital conditions are present. In order to mitigate this problem at the United States Naval Academy, Capt. Adam Saperstein, Admissions Medical Officer for the U.S. Naval Academy, Capt. Alaric Franzos, Director for Medical Readiness at U.S. Navy Bureau of Medicine and Surgery, and Dr. Mark Haigney of the Military Cardiovascular Outcomes Research program at Uniformed Services University, initiated a program to enhance the current screening approach with the addition of an electrocardiogram.
An electrocardiogram measures the electrical signal generated by the heart and is abnormal in 80% of those with cardiac conditions associated with sudden cardiac death. Previously, the electrocardiogram was removed from routine entrance screening due to an unacceptably high number of “false positive” exams that unnecessarily delayed recruit training, led to large expenditures on unnecessary cardiac tests, and improperly disqualified otherwise healthy applicants.
In a new approach, a specialized electrocardiogram specifically used for young athletes has been added to the usual historical and physical examination recommended by the American Heart Association. Since July 20th, the team has evaluated 1178 incoming plebes. The examination has proven expeditious, taking less than 10 minutes to perform, and allows 80 midshipmen to be screened daily by only two Hospital Corpsmen overseen by Haigney, who describes it as a game-changer.
“This new device is increasing performance, reliability, and optimizing our evaluation of midshipmen,” said Haigney. “Hopefully, this trial will demonstrate that we can save lives.”
Saperstein agreed stating, “To date, approximately 2% of those screened have been referred to Walter Reed National Military Medical Center for further evaluation, less than expected and far less than traditional electrocardiograms.”
The rest of the U.S. Naval Academy will be screened pending a favorable evaluation of the new approach. The process will be considered as an additional component to the current screening of all Navy recruits if this updated device identifies previously missed cardiovascular issues during the entrance exam process and does not overburden the existing system.
“By partnering with experts within Navy Medicine and trying out a new, more efficient test that provides good data in order to ensure a medically ready force, we are able to enhance naval superiority here in Annapolis,” said Capt. Walter Brafford, Commanding Officer of Naval Health Clinic Annapolis.
Since 1845, Naval Health Clinic Annapolis (NHCA) has been committed to exemplifying the best of Navy Medicine though innovation, quality care, technology, talent management, and leadership. NHCA provides health support in six locations across three states, at our core is the care and commissioning readiness of the Brigade of Midshipmen, 4500 strong. NHCA providers contribute to athlete development on and off the field and cover as team physician for 33 varsity sports teams and 26 club sports.