Why the study?
Sudden cardiac death is the leading cause of death in young athletes during sports participation, prompting the need to review screening recommendations, recent evidence, and current practice.
Does the inclusion of ECG in preparticipation cardiovascular screening improve the identification of conditions with increased risk of sudden cardiac death in young athletes compared to history and physical examination alone?
Does the inclusion of ECG in preparticipation cardiovascular screening improve the identification of conditions with increased risk of sudden cardiac death in young athletes compared to history and physical examination alone?
Current evidence remains mixed on the routine inclusion of ECG in preparticipation screening for young athletes, supporting current US guidelines that recommend history and physical examination as the primary screening tool.
Mixed evidence supports caution against routine ECG addition to screening; leaves open need for definitive trials on sudden death prevention.
PURPOSE OF REVIEW: Sudden cardiac death (SCD) is the leading cause of death in young athletes during sports participation. Preparticipation cardiovascular screening aims to identify those at an increased risk of SCD. This review aims to provide a background of SCD in young athletes, to discuss the various screening recommendations of major medical societies, and to review recent evidence and current practice. RECENT FINDINGS: Numerous studies have evaluated various preparticipation screening practices, particularly regarding the inclusion of ECG as part of an initial evaluation to identify conditions with an increased risk of SCD. Some analyses have shown ECG inclusion to provide increased screening sensitivity and specificity, though others have shown no benefit when compared with evaluation with history and physical examination alone. Furthermore, in countries for which more extensive screening protocols have been employed, postimplementation statistics have not shown a significant decrease in SCD. SUMMARY: SCD in young athletes primarily results from underlying cardiac disease. Various preparticipation screening recommendations exist globally, with the common goal of decreasing the rates of SCD by identifying youth at risk during sports participation. Current guidelines in the United States support universal preparticipation evaluation using history and physical examination, with cardiology referral if abnormalities are identified.
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Donovan et al. (2023) studied this question.
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