The pre-participation screening in young athletes: which protocol do we need exactly?

Area of Science:

• Cardiology
• Sports Medicine
• Preventive Cardiology

Background:

• Young athletes undergo pre-participation screening to detect conditions that could increase sudden cardiac death risk.
• A comprehensive cardiac screening protocol was evaluated for its utility and feasibility in this population.

Purpose of the Study:

• To assess the effectiveness of a detailed cardiac screening protocol in identifying cardiovascular abnormalities in young athletes before sports participation.

Main Methods:

• A cohort of 380 young athletes (mean age 12.4 years) underwent a protocol including history, physical exam, 12-lead ECG, echocardiography, Holter monitoring, and exercise testing.
• Data were collected between April 2014 and April 2015.

Main Results:

• Common complaints included chest pain (5%) and dyspnea (3.4%). Family history revealed sudden death/arrhythmia in 10.7%.
• Physical exam identified murmurs (5.2%) and hypertension (2.6%). ECG abnormalities were found in 2.4%, echocardiography in 1.3% (hemodynamically significant), Holter in 1.5%, and exercise tests in 0.5%.
• No significant correlation was found between initial screening findings and results from echocardiography, Holter, or exercise tests.

Conclusions:

• Pre-participation screening for young athletes should prioritize targeted personal and family history, physical examination, and 12-lead ECG.
• Advanced cardiac investigations like echocardiography, Holter, and exercise testing should be reserved for cases where initial screening suggests underlying cardiovascular disease.