What is the clinical evidence from this study?

Study design: Observational. Population: Asymptomatic children seeking sports license (n=2089). Intervention: Pre-participation screening with ECG and echocardiography. Primary outcome: Detection of cardiac abnormalities.

What does this research mean for the field?

Routine pre-sport cardiac evaluation using electrocardiography and echocardiography detects previously unknown cardiac abnormalities in approximately 9.3% of asymptomatic children, with 2.3% having major cardiac problems. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to identify cardiac abnormalities in children before they participate in sports, assessing risks beyond sudden cardiac death.

June 8, 2026Annals of Noninvasive Electrocardiology0 citationsOpen Access

Pre‐Sport Cardiac Evaluation in Children: Detection of Risks Other Than Sudden Cardiac Death

MÖMehmet ÖncülMalatya Devlet Hastanesi AGAbdulgani GülyüzMalatya Turgut Özal Üniversitesi

Key Result

Pre-participation screening with ECG and echocardiography in asymptomatic children detected cardiac abnormalities in 9.3% of cases, including major cardiac problems in 2.3%.

Key Points

This study aims to identify cardiac abnormalities in children before they participate in sports, assessing risks beyond sudden cardiac death.
Pediatric patients seeking sports license evaluations at Malatya Training and Research Hospital were included.
Data were collected and analyzed using SPSS 22.0.
Patients without prior known heart disease were evaluated with echocardiography and electrocardiography.
Out of 2432 patients, 195 (9.3%) were found to have cardiac problems.
Echocardiography revealed abnormalities in 169 (8.1%) patients, while electrocardiography showed abnormalities in 33 (1.7%).
Elevated arterial blood pressure was detected in three patients (0.14%).

Study Design

Type

Observational (n=2,089)

Multicenter

Structured PICO

What is the prevalence of cardiac abnormalities detected by ECG and ECHO during pre-sport evaluation in pediatric patients without known heart disease?

Population

2,089 asymptomatic children and adolescents aged 5 to 18 years undergoing pre-participation sports screening with ECG and echocardiography.

Exposure

Pre-sport cardiac evaluation including electrocardiography (ECG) and echocardiography (ECHO).

Outcome

Detection of cardiac abnormalities (ECHO and ECG abnormalities).

Pre-sport cardiac screening with ECG and ECHO in children without known heart disease detects cardiac abnormalities in nearly 10% of cases, supporting detailed early cardiac evaluation.

Limitations

Retrospective design
Missing detailed anamnesis, family history, and physical examination data

Abstract

OBJECTIVE: Sudden deaths may occur in children and adolescents due to unexpected cardiac problems during sports. This study aimed to screen for abnormalities that may lead to future morbidity in addition to the risk of sudden death and to investigate the importance of electrocardiography and echocardiography in detecting cardiac problems before sports license. METHOD: Pediatric patients who visited the Pediatric Cardiology outpatient clinic of Malatya Training and Research Hospital between April 2022 and April 2024 to obtain a sports license report and who did not have any known heart disease before were included. Data were analyzed using SPSS 22.0. RESULTS: A total of 2432 patients were admitted to our hospital for pre-sport evaluation within 2 years. In 2089 of those, there were no known heart problems. Various heart problems were detected in 195 (9.3%) of the 2089 cases. In our study, 169 (8.1%) patients had echocardiography (ECHO) and 33 (1.7%) had electrocardiography (ECG) abnormality. Eight patients (0.3%) showed pathological findings on both ECHO and ECG. In addition, elevated arterial blood pressure was detected in three (0.14%). Of the cases with cardiac abnormality, 110 (56%) were male and 85 (46%) were female, and the average age was 12 (5-18). CONCLUSION: Our study shows that approximately one out of every 10 patients in the population may have cardiological problems and 2.3% of these patients have major cardiac problems. Therefore, we recommend that all pediatric patients undergo a detailed cardiac evaluation at least once in the early stages of their lives.

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