Pre-participation screening for hypertrophic cardiomyopathy in young athletes

Aims: This literature review seeks to explore the efficacy of pre-participation screening (PPS) in identifying hypertrophic cardiomyopathy (HCM) and preventing sudden cardiac death (SCD) in young athletes within the UK. Background: SCD accounts for half of all cardiovascular mortality in persons under 30 years and HCM is the leading cause of exercise-related cardiovascular death in young athletes. Substantial interest persists regarding the effectiveness of PPS and the necessity for universal legislation and implementation. Findings: PPS of young athletes identified HCM (and other cardiovascular disease) that could have prevented SCD. Electrocardiography (ECG) had virtuous impact when included within PPS. However, echocardiography—noted as gold standard assessment of HCM—was largely insignificant. SCD had greater prevalence in males than females, yet there was significant ethnic underrepresentation. PPS lacked consistency. Conclusion: PPS is universally divisive and present legislative application in the UK remains unfounded. There is evidence highlighting the efficacy of PPS identifying HCM (and other cardiovascular disease), and thus preventing SCD in young athletes. ECG inclusion could have benefits in PPS. However, further studies targeting age, sex, ethnicity, cost analysis and consistency are imperative before PPS is mandated. Relevance to clinical practice: Essential practical, psychological and ethical implications govern PPS implementation, illustrating expert clinical nursing support and prospective intervention in SCD aftermath.