AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes: Current Evidence, Knowledge Gaps,...

Area of Science:

• Sports Medicine
• Cardiology
• Preventive Cardiology

Background:

• Cardiovascular (CV) screening is recommended for young athletes to prevent sudden cardiac arrest and death (SCA/D).
• Debate exists regarding the optimal CV screening strategy, particularly the addition of electrocardiograms (ECGs) to history and physical exams.
• The American Medical Society for Sports Medicine (AMSSM) addressed evidence gaps from a primary care sports medicine perspective.

Purpose of the Study:

• To address current evidence and knowledge gaps in preparticipation CV screening for athletes.
• To present a new paradigm for physicians to select appropriate CV screening strategies.
• To guide physicians in balancing the benefits and harms of CV screening methods.

Main Methods:

• A task force was formed by the AMSSM to review existing evidence on CV screening in athletes.
• The statement outlines a new paradigm for individualized CV screening strategy selection.
• Consideration of SCA/D risk, athlete population, community needs, and resources is emphasized.

Main Results:

• The AMSSM cannot endorse a single universal CV screening strategy due to a lack of definitive outcomes-based evidence.
• A new paradigm is proposed to assist physicians in tailoring screening strategies.
• The decision to implement screening, with or without ECG, requires careful risk-benefit analysis.

Conclusions:

• Individual physician assessment, considering emerging evidence, is crucial for selecting the most beneficial CV screening model.
• The AMSSM advocates for evidence-based research to validate effective strategies for safe sports participation and reduced SCA/D.
• Physicians must weigh the risks of SCA/D against the benefits of screening in their specific athlete populations.