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

Area of Science:

• Sports Medicine
• Cardiology
• Preventive Health

Background:

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

Purpose of the Study:

• To evaluate current evidence and knowledge gaps in preparticipation cardiovascular screening for athletes.
• To propose a new paradigm for individualized cardiovascular screening strategies.
• To guide physicians in selecting appropriate screening based on athlete population, community needs, and resources.

Main Methods:

• A task force was formed by AMSSM to review existing evidence on cardiovascular screening in athletes.
• Analysis focused on the role of resting electrocardiograms (ECG) in addition to history and physical examination.
• Consideration of risk of SCA/D, cardiology resources, and infrastructure was emphasized.

Main Results:

• Absence of definitive outcomes-based evidence prevents endorsement of a single, universal screening strategy.
• A new paradigm is presented to aid physicians in tailoring screening approaches.
• The decision to implement screening, with or without ECG, requires careful risk-benefit assessment.

Conclusions:

• No single cardiovascular screening strategy is universally endorsed due to insufficient evidence.
• Physician-led, individualized assessment is crucial for determining the most beneficial screening approach.
• AMSSM advocates for research to validate effective strategies for safe sports participation and reduced SCA/D.