The AMSSM does not endorse a single universal cardiovascular screening strategy for all athletes due to the absence of definitive outcomes-based evidence, recommending individualized assessment.
What is the optimal strategy for cardiovascular preparticipation screening in athletes to prevent sudden cardiac arrest and death?
The AMSSM position statement provides a framework for physicians to individualize cardiovascular preparticipation screening in athletes based on population risk and available resources, rather than mandating a universal ECG screening strategy.
Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the center of the controversy is the addition of a resting electrocardiogram (ECG) to the standard preparticipation evaluation using history and physical examination. The American Medical Society for Sports Medicine (AMSSM) formed a task force to address the current evidence and knowledge gaps regarding preparticipation cardiovascular screening in athletes from the perspective of a primary care sports medicine physician. The absence of definitive outcomes-based evidence at this time precludes AMSSM from endorsing any single or universal cardiovascular screening strategy for all athletes, including legislative mandates. This statement presents a new paradigm to assist the individual physician in assessing the most appropriate cardiovascular screening strategy unique to their athlete population, community needs, and resources. The decision to implement a cardiovascular screening program, with or without the addition of ECG, necessitates careful consideration of the risk of SCA/D in the targeted population and the availability of cardiology resources and infrastructure. Importantly, it is the individual physician's assessment in the context of an emerging evidence-base that the chosen model for early detection of cardiac disorders in the specific population provides greater benefit than harm. AMSSM is committed to advancing evidenced-based research and educational initiatives that will validate and promote the most efficacious strategies to foster safe sport participation and reduce SCA/D in athletes.
Drezner et al. (Thu,) conducted a review in Cardiovascular preparticipation screening in athletes. Cardiovascular screening (with or without resting ECG) was evaluated. The AMSSM does not endorse a single universal cardiovascular screening strategy for all athletes due to the absence of definitive outcomes-based evidence, recommending individualized assessment.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: