Cardiac Screening in Athletes: Current Status and Future Challenges.

Area of Science:

• Cardiology
• Sports Medicine
• Preventive Cardiology

Background:

• Pre-participation screening (PPS) is vital for identifying athletes at risk of sudden cardiac death (SCD).
• Despite evidence of effectiveness, a universal PPS protocol is lacking.
• Key screening components include medical history, physical exam, and electrocardiogram (ECG).

Purpose of the Study:

• To review the current state of cardiac screening in athletes.
• To highlight ongoing challenges in ECG interpretation and screening protocols.
• To outline future directions for enhancing PPS effectiveness and sustainability.

Main Methods:

• Literature review of current pre-participation screening practices.
• Analysis of challenges in differentiating athlete's heart from cardiac disease.
• Examination of underrepresented athlete subgroups in current research.

Main Results:

• No universal PPS protocol exists, despite common elements like ECG.
• Challenges remain in ECG interpretation due to overlap with physiological changes in athletes.
• Certain athlete groups, including females, masters, and pediatrics, are underrepresented.

Conclusions:

• Effective PPS requires public health policy support and cost-effectiveness recognition.
• Enhancing screening tool sensitivity and specificity is essential to minimize misdiagnosis.
• Future efforts must focus on improving accuracy, equity, and sustainability in athlete cardiac screening.