Sudden cardiac death among athletes continues to take the lives of college students across the nation. Leadership at all levels of higher education has great concern over this phenomenon. However, the processes and procedures related to hypertrophic cardiomyopathy (HCM) remain poorly understood. Corrado (1998) suggests that sudden cardiac death of student-athletes due to HCM can be avoided if individuals at risk are identified and their participation in his or her respective sports is limited. However, new research has questioned the accuracy of these claims creating a strong need for additional research (Thompson, 2006). The purpose of this study is to investigate the cardiovascular screening process at NCAA Division I institutions of higher education in the Northeast. The following research questions were developed: (1) What should the preparticipation cardiac screening process consist of at NCAA Division I higher education institutions in the Northeast? (2) What other actions should NCAA Division I higher education institutions in the Northeast do to reduce the possibility of harm for student-athletes participating in intercollegiate athletics? (3) What are the channels of communication that should exist in regards to sudden cardiac death of student-athletes and preparticipation examination screening? This study employed a grounded theory design combined with responsive interviewing as the data collection strategy. An open-ended interview protocol was used during the individual interviews. Data collection and analysis were conducted through the constant comparative method. Participants in the study (N = 15) were athletic directors, medical experts, and directors of sports medicine at NCAA Division I institutions in the Northeast. Participants were selected through theoretical sampling, a standard procedure during grounded theory studies. The principle findings of the study include the following themes: "Polarized Uncertainty, Incremental Procedures" (e.g., better family health history, education, emergency response action plan, and CPR certification for Division I coaches), "Mitigating Factors, Expert Initiated Communication", and "Additional Research". The findings suggest that NCAA Division I institution of higher education need more empirical evidence to proceed with any level of certainty. Potential contributions of this study include improved policies at analogous institutions, future research, and best practices. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]