Does preseason screening for cardiac disease really work?: the British perspective

Area of Science:

• Cardiology
• Sports Medicine
• Public Health

Background:

• Sudden cardiac death (SCD) during sports is a tragic event, often perceived as contradictory to the health benefits of physical activity.
• Both the public and medical professionals seek methods to prevent SCD in athletes.
• Preparticipation medical screening is frequently proposed as a preventative strategy.

Purpose of the Study:

• To evaluate the utility of widespread preparticipation medical screening for preventing sudden cardiac death in sports.
• To assess the risk of death, prevalence of underlying conditions, disease natural history, and available screening methods.

Main Methods:

• Review of existing literature on SCD in athletes.
• Analysis of the prevalence of cardiac conditions predisposing to SCD.
• Examination of the natural history of these conditions.
• Evaluation of the effectiveness and feasibility of current screening protocols.

Main Results:

• Widespread screening is deemed not useful when considering the low prevalence of at-risk conditions.
• The natural history of underlying diseases and the limitations of screening methods further support this conclusion.
• Systematic preparticipation screening is not widely implemented in the United Kingdom.

Conclusions:

• Systematic preparticipation screening is not a cost-effective or efficient strategy for preventing SCD in the general sports population.
• The current lack of widespread screening in the UK is an evolutionary practice rather than a result of a deliberate policy.
• Further research may be needed to identify specific high-risk groups or refine screening protocols for targeted application.