EKGs at MEPS...

[Devildoc]

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 in the overall population who have EKG changes with exercise and exertion.

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

 

[Johca]

From the article: "EKGs were part of routine screening to join the U.S. military as recently as 2002. But they were notoriously famous for false positives, requiring expensive follow-on medical testing and handing young people potentially life-changing misdiagnoses, so they were dropped by the services." However false positives is misleading as an abnormal EKG only identifies something is potentially a problem but not what is the problem.

An EKG only assessing one function involved in the heart functioning as a pump. EKGs focus on the nerves causing an efficient coordinated contraction of the four chambers of the heart of which the cardiac muscle can have significant damage before EKG indicates this damage existing. Valve function and also be impaired sufficient to cause a heart mummer to be heard long before it causes a change in the EKG. The same difficulty exists pertinent to extent of blockage present in the veins and arteries and capillaries of the heart.

Cocaine Heart Attack and Symptoms of Other Cardiovascular Effects <--What isn't mentioned in this article is higher blood pressure can also cause damage to the blood vessels of liver a condition called portal hypotension. The military autopsies tend to avoid making any determination of recreational drug use being a contributing factor as wokeness prevailing in the US tends to frown on labeling cause of death doing PT having a contributing causal factor of illicit drug use or an illicit drug use habit.

All these factors contribute requiring expensive follow-on medical testing which was avoided by being Medically Disqualified at MEPS during the MEPS medical examination. Cost effective when the supply population willing to volunteer for military service was mostly healthy and numerically significantly exceed the numbers being medically disqualified.

 

[Devildoc]

Well, there are a lot of issues with a single, resting EKG (even as a 'baseline'). To your point @Johca 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.

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

 

[Johca]

Agree with all and specifically the doing a stress test and "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."

 

[Kaldak]

Do recruits no longer have to pass a PT test with the recruiter? Shouldn't that tell you all you need to know?

As a layman, to maybe catch a 1 out of 10,000 (50,000? More?) case seems like a needless hurdle/expense to add to an already overly involved process.

This will will surely help with the recruiting and retention woes. Not correcting poor leadership and culture, but more tests before entry.

 

[Devildoc]

Do recruits no longer have to pass a PT test with the recruiter? Shouldn't that tell you all you need to know?

As a layman, to maybe catch a 1 out of 10,000 (50,000? More?) case seems like a needless hurdle/expense to add to an already overly involved process.

This will will surely help with the recruiting and retention woes. Not correcting poor leadership and culture, but more tests before entry.

A PT test today, I have no clue. When I joint, I did not do one with the recruiter. All he cared about was my physical and ASVAB scores.

This is definitely a box for them to check, for them to say they did their due diligence regarding liability and to make themselves feel better.

 

[Kaldak]

A PT test today, I have no clue. When I joint, I did not do one with the recruiter. All he cared about was my physical and ASVAB scores.

This is definitely a box for them to check, for them to say they did their due diligence regarding liability and to make themselves feel better.

I had to do a PT when I went into the Marines and again when I reentered to go OCS with the Army. Granted, the second one was competitive, and that was part of the selection packet.

With the Marines they had us do group PT as poolees up until our ship date. It was a requirement unless you had a conflicting sporting event.

I made the mistake of assuming that was still the case.

 

[Muppet]

I'd venture to say, 12 lead with echo would better be used to rule out cardiac issues. Though, it won't pick up things like WPW that may not show up on 12.

 

[Stretcher Jockey]

Would be really interested to see how this affects VA ratings. Now that everyone entering will have a baseline EKG, anything found thereafter with an accompanying diagnosis/clinical picture would be an easy kill. Overall I’m not against it since it’s a cheap and easy screening that will give people the warm fuzzies about joining. Getting dicked down by leadership is something you earn once you’re in.