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    Identifying athletes at risk for sudden death during exercise is challenging due to costly screening. A targeted history focusing on symptoms and family history of congenital heart disease offers a practical approach for athletes.

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    Area of Science:

    • Cardiology
    • Sports Medicine
    • Preventive Cardiology

    Background:

    • Exercise-related sudden death in athletes is a significant concern.
    • Current reliable screening methods for identifying at-risk athletes are often expensive and impractical.
    • Standard physical examinations and medical histories may not detect underlying congenital heart disease (CHD) that predisposes athletes to sudden death.

    Purpose of the Study:

    • To evaluate the challenges in identifying athletes at risk for exercise-related sudden death.
    • To explore practical screening strategies for congenital heart disease in athletes.
    • To determine the most feasible approach for athlete screening to prevent sudden cardiac events.

    Main Methods:

    • Review of existing literature on athlete screening and exercise-related sudden death.
    • Analysis of the limitations of current diagnostic tools for congenital heart disease in athletic populations.
    • Assessment of the potential utility of targeted historical data collection.

    Main Results:

    • Comprehensive screening for all athletes is logistically difficult and costly.
    • Even perfect screening would require testing a large number of athletes to identify a few at risk.
    • A focused medical history, specifically inquiring about symptoms and family history of CHD, emerges as a potentially practical screening tool.

    Conclusions:

    • Identifying all athletes susceptible to exercise-related sudden death remains a complex issue.
    • The high cost and low yield of universal screening limit its effectiveness.
    • A practical screening strategy may involve a targeted history focusing on symptomatic individuals and those with a family history of congenital heart disease.