4.4 Review

The cardiac preparticipation sports evaluation

Journal

CURRENT OPINION IN PEDIATRICS
Volume 35, Issue 5, Pages 546-552

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOP.0000000000001284

Keywords

cardiac; cardiovascular; sports preparticipation evaluation; sudden cardiac arrest; sudden cardiac death; youth athletes

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The purpose of this review is to discuss sudden cardiac death (SCD) in young athletes, the different preparticipation screening recommendations, and recent evidence and current practice. SCD in young athletes is primarily caused by underlying cardiac disease. There are various preparticipation screening recommendations globally with the goal of identifying at-risk youth and reducing SCD rates.
Purpose of reviewSudden 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 findingsNumerous 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.SummarySCD 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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