Risk-based, symptom-driven preparticipation evaluation is recommended for recreational athletes, who face a sudden cardiac arrest or death incidence of 0.02 to 13 per 100,000 person-years.
A risk-based, symptom-driven preparticipation evaluation is recommended for recreational athletes to enhance safety and reduce unnecessary testing compared to universal ECG screening.
BACKGROUND: Regular physical activity confers substantial cardiovascular benefits, yet it may in rare cases precipitate sudden cardiac arrest (SCA) or sudden cardiac death (SCD) in predisposed individuals. Although preventive frameworks have largely targeted competitive athletes, the rapidly expanding population of recreational participants remains insufficiently addressed. CASE SUMMARY: Recreational athletes have a low but significant incidence of SCA/SCD (0.02 to 13 per 100,000 person-years). Coronary artery disease is most common in middle-aged individuals, while inherited cardiomyopathies account for fewer cases. DISCUSSION: Contemporary preparticipation evaluation for recreational athletes has shifted from universal electrocardiogram-based screening to a risk-stratified, individualized approach emphasizing cardiovascular assessment, symptom recognition, and selective testing based on exercise intensity. Digital and wearable technologies are under evaluation to support symptom-triggered assessment and cardiac rhythm documentation; however, their effectiveness for preventing sports-related SCA/SCD and their optimal clinical workflows remain unproven. TAKE-HOME MESSAGE: Risk-based, symptom-driven preparticipation evaluation enhances safety, reduces unnecessary testing, and promotes lifelong participation in recreational sports.
Zhang et al. (Sat,) conducted a review in Sudden cardiac arrest or sudden cardiac death in recreational athletes. Risk-based, symptom-driven preparticipation evaluation vs. Universal electrocardiogram-based screening was evaluated on Incidence of sudden cardiac arrest or sudden cardiac death. Risk-based, symptom-driven preparticipation evaluation is recommended for recreational athletes, who face a sudden cardiac arrest or death incidence of 0.02 to 13 per 100,000 person-years.