Recommendations for Preparticipation Cardiovascular Screening for Athletes in Saudi Arabia: A Consensus Statement from the National Heart Center, Saudi Heart Rhythm Society, and National Center for Sudden Death

Vigorous sports participation provides substantial physical and psychological benefits but may be accompanied by a small risk of sudden cardiac arrest and death in individuals with previously unrecognized cardiovascular disease. Preparticipation cardiovascular screening aims to identify athletes at increased risk, facilitate appropriate evaluation and management, and promote safe participation in sport. Despite growing international experience, no national recommendations have previously existed for Saudi Arabia. Recognizing the rapid expansion of organized sports participation driven by Saudi Vision 2030, an expert panel convened to develop consensus recommendations for the implementation of a nationwide preparticipation cardiovascular screening program. A comprehensive review of contemporary literature, international clinical practice guidelines, consensus statements, and landmark studies was undertaken, with emphasis on the epidemiology of sudden cardiac arrest and death, screening modalities, diagnostic performance, cost-effectiveness, and implementation strategies. Based on the available evidence and expert consensus, practical recommendations were formulated regarding the target population, screening protocol, timing and frequency of screening, referral pathways, downstream evaluation, and emergency preparedness. A standardized screening and referral algorithm is proposed to facilitate consistent nationwide implementation. These recommendations provide the first national framework for preparticipation cardiovascular screening and aim to improve athlete safety while supporting the continued growth of sports participation in Saudi Arabia.