Youth and athletic screening: Rationale, methods and outcome

Abstract

Sudden cardiac death is a tragic event under any circumstance, but is especially devastating when it occurs in youth and athletes. In the ‘paradox of sports’, exercise both promotes health and acutely increases the risk of SCD among those with underlying heart disorders such as HCM, arrhythmogenic right ventricular cardiomyopathy, or coronary artery anomalies. Developed societies agree that pre-participation screening is valuable and warranted to improve the safety of sports competition, but there remain significant differences in opinion regarding the best methods to employ. ECG screening in particular remains controversial, with European societies generally in favor of ECG and US guidelines against ECG inclusion. New, athlete-specific ECG criteria may decrease the false positive rate, but the sensitivity and specificity of these criteria have not yet been established.