MEPS to get EKGs on recruits...

[Chuckman]

...in an effort to rule out previously undiagnosed and potentially dangerous cardiac issues. I would be curious to know what percentage a baseline resting EKG will reveal issues in the overall population who have EKG changes only with exercise and exertion. I do not know if it's a good idea or bad idea (probably good), but I think the total catchment for something bad will be extremely small.

US Military to Screen All New Recruits for Heart Conditions Under Must-Pass Annual Defense Bill

The requirement, included in the fiscal 2024 National Defense Authorization Act, follows a series of deaths among military personnel and years of lobbying by Gold Star parents.

www.military.com

 

[SDIVER2006]

Good….also need to screen out for the mental health stuff too…

 

[Tim]

Since you can get a reasonably accurate EKG on a smart watch theses days, I'm not surprised they're doing it. Cost to deploy the EKG equipment must have gone down tremendously. And, an EKG takes maybe 5 minutes to do?

 

[Chuckman]

Since you can get a reasonably accurate EKG on a smart watch theses days, I'm not surprised they're doing it. Cost to deploy the EKG equipment must have gone down tremendously. And, an EKG takes maybe 5 minutes to do?

Yes, short test. And the tech is much more prevalent and less expensive than it used to be.

Good….also need to screen out for the mental health stuff too…

They do this a bit, but far too little, and I think they don't see the forest for the trees. They will DQ someone who has ADHD but waiver someone else who saw a counselor for unspecified reasons.

 

[Diablos]

with the number of anxiety ratings i've seen (total bs), i say screen em and screen em hard

and with the cost of long term health care (the health care itself and disability payments), this is a no brainer.

 

[BlackGun]

It’s also amazing how many young soldiers sleep with a CPAC. But right now they are taking just about anyone who applies without a felony.

 

[Chuckman]

The problem is that a single snapshot of one resting EKG really isn't going to rule in much.

There are a lot of issues with a single, resting EKG (even as a 'baseline'). It really cannot diagnose any valve issues (in which you need an EKG with an echocardiogram). If there is significant vascular disease cause hypoxia to cardiac muscle (via stenosis), it can see that, but in a resting EKG it has to be somewhat advanced. Normally you don't see significant changes until there is an activity, which is why one does an exercise stress test. Then the 12-lead turns into all sorts of excitement and drama.

Hypertension, pharmacology (legal, illicit, and OTC), some electrolyte issues, and some other diseases can alter an EKG. Of course a resting EKG can show prior cardiac damage, cardiomyopathy/hypertrophy, a handful of other things, but by and large it's just a snapshot, a single picture, of what is going on with the heart at that time in almost all healthy people.

If the military wanted to take it seriously, they would do an exercise stress test (which includes an echo), but now we're moving into huge big-$ territory, making it cost-prohibitive.

Of course, boot camp/basic does an exercise stress test on everyone: if you are doing PT and don't have chest pain, you don't have ischemia, so then you don't have a positive stress test. The only thing missing is an EKG and echo, which in 99.5% of asymptomatic people would reveal a negative test. But a resting EKG is cheap and easy and would be helpful for old farts like me down the line.

I would wager that most sudden deaths in the apparently healthy, young military-age population come from undiagnosed congenital issues or pharmacology-related issues.

 

[rodell]

With the proper software, a real EKG (meaning a 12 lead not the thing you get on your watch) can screen for lots of things, including the risk of Sudden Cardiac Death. It isn't perfect, but it does work and is proven. For youth, athletes and those in strenuous professions it is well worth it. If I had a youngster in sports, I would insist on a screening. There are many foundations that go from high school to high school providing free screenings - most are run by the parents of kids who could have been diagnosed and suffered sudden cardiac death. Here's one such foundation: Who We Play For.

Only 16 seconds of ECG data is required to make the calls, too. It takes longer for the hookup than the interpretation. As has been pointed out, there are the usual things you can get from a 12-lead, too. Any screening is better than none.

Chuckman is correct - SCA in apparently healthy people is usually congenital, most often Wolff-Parkinson-White (WPW) syndrome but there are others.

 

[363medic]

Honestly this makes decent sense, they are just trying to rule out things like hypertrophic obstructive cardiomyopathy, wolf parkinson white, arrythmogenic right ventricular cardiomyopathy, and other potential causes of sudden death in seemingly healthy young people. Many of these syndromes have characteristic ECG patterns so it’s a whole lot easier to spend 5 min and get an ECG in MEPS than to 1) have some recruit drop dead while doing PT in basic (less likely scenario) or 2) discover incidentally that a service member has one of these conditions during a work up for a syncopal event and then have to go through the long, expensive process of a medical discharge/retirement (more likely scenario). Either way doing a screening ECG in MEPS to find rare but serious conditions BEFORE you accept a recruit into service is a pretty cheap and easy insurance policy against potential headaches down the road.

 

[Chuckman]

Honestly this makes decent sense, they are just trying to rule out things like hypertrophic obstructive cardiomyopathy, wolf parkinson white, arrythmogenic right ventricular cardiomyopathy, and other potential causes of sudden death in seemingly healthy young people. Many of these syndromes have characteristic ECG patterns so it’s a whole lot easier to spend 5 min and get an ECG in MEPS than to 1) have some recruit drop dead while doing PT in basic (less likely scenario) or 2) discover incidentally that a service member has one of these conditions during a work up for a syncopal event and then have to go through the long, expensive process of a medical discharge/retirement (more likely scenario). Either way doing a screening ECG in MEPS to find rare but serious conditions BEFORE you accept a recruit into service is a pretty cheap and easy insurance policy against potential headaches down the road.

It's cheap, it's easy, so from that standpoint there's no real downside. If it was expensive I would push back for a test that might rule out 0.001% of the recruit population.