Preparticipation electrocardiogram screening in a Gulf Coast community: A prospective study

Area of Science:

• Cardiology
• Sports Medicine
• Preventive Cardiology

Background:

• Sudden cardiac death (SCD) in young athletes is a critical concern in sports.
• Current screening methods, including questionnaires, have limitations in detecting underlying cardiac pathologies.
• Debate persists regarding the optimal screening strategy for young athletes.

Purpose of the Study:

• To compare the effectiveness of a 12-lead electrocardiogram (ECG) versus a preparticipation questionnaire in detecting life-threatening cardiac conditions in young athletes.
• To evaluate the sensitivity and specificity of both screening methods.

Main Methods:

• A prospective study involving 2604 students aged 5-22 years in coastal Alabama.
• Participants completed the 14-point American Heart Association (AHA) preparticipation questionnaire.
• All participants underwent a 12-lead ECG screening.

Main Results:

• The AHA questionnaire identified symptoms in 11.9% of students, but missed 66.0% of critical cardiac pathologies.
• The 12-lead ECG revealed abnormalities in 3.3% of students, with 100% sensitivity and 97.0% specificity for life-threatening conditions.
• ECG detected three cases of conditions associated with sudden cardiac arrest, only one of which was flagged by the questionnaire.

Conclusions:

• The 12-lead ECG is a superior screening tool for identifying life-threatening cardiac pathologies in young athletes compared to the AHA questionnaire.
• ECG screening demonstrates higher sensitivity and specificity, significantly reducing the risk of missed diagnoses.
• Implementing ECG screening can enhance the safety of young athletes by detecting conditions that questionnaires might overlook.