Preparticipation Screening Research Articles

Can standardized criteria enhance the accuracy of the interpretation of ECGs in pre-participation screening?

Can standardized criteria enhance the accuracy of the interpretation of ECGs in pre-participation screening?

Demographics, culture and participatory nature of multi-marathoning-An observational study highlighting issues with recommendations.

The defining achievement of a multi-marathoner is completing 100 marathons. This study aimed to comprehensively document the phenomenon of multi-marathoning, addressing its demographics, culture and participatory nature, filling a gap in peer-reviewed research on the topic. Additionally, it aimed to provide recommendations for multi-marathon governing bodies, event organisers, health professionals and participants to address identified issues. A global survey was distributed to participants and individuals interested in multi-marathoning. It was distributed with support from major national and international multi-marathon clubs through their social media channels, email groups and newsletters. The survey was conducted anonymously and online. The survey garnered responses from 830 participants across 40 countries, with an average marathon completion count of 146.54 (SD 201.83) per respondent. Gender distribution showed 60.69% men, 39.3% women and 0.1% gender variant/non-conforming. Respondents' average ages were 51.6 (SD 9.96) years for men, 48.83 (SD 9.15) years for women and 35.00 (SD 8.76) years for gender variant/non-conforming. As participants age, social and travel motivations surpass competitiveness. A majority (57%) of respondents had at least one contravention to the pre-participation screening questionnaire PARQ-+ and 67% reported taking pain relief medication around events. Notably, 93% of respondents reported multi-marathoning as beneficial for their mental health. Multi-marathoning accommodates older athletes, but a significant gender imbalance exists in participation levels. Long-term health implications warrant attention from governing bodies, event organisers, health professionals and participants alike. Multi-marathoners should seek medical advice before participation, utilise modern equipment for health monitoring and optimise training accordingly. Recommendations include encouraging diversity at events, ensuring event directors have well-resourced health plans and promoting participants' proactive health management before and during their involvement in the sport. This study not only advances our understanding of multi-marathoning as a sport but also contributes to theoretical frameworks such as SDT and HBM.

Differences regarding symptoms of SARS-CoV-2-Infection in pediatric and adolescent athletes in comparison to adult athletes

BackgroundMost children are afflicted by a mild SARS-CoV-2-infection course in comparison to adults. However, data about differences between the experienced symptoms of pediatric/adolescent in comparison to adult athletes are sparse. MethodsCompetitive athletes of any age, who presented for preparticipation screening 04/2020–10/2021 with confirmed SARS-CoV-2-infection were included in this study, stratified for pediatric/adolescent (≤18years) or adult age (>18years) and both age-groups were compared regarding symptoms. ResultsOverall, 157 athletes with former SARS-CoV-2-infection (mean age 22.0 [18.0/27.0] years; 35.0 % females) were included in our study 04/2020 – 10/2021; among them, 40 (25.5 %) were pediatric/adolescent and 117 (74.5 %) adult athletes.Pediatric/adolescent athletes had significantly more often an asymptomatic SARS-CoV-2-infection (22.5% vs. 6.0 %, P = 0.003). Symptoms of cold and flu-like symptoms (81.2% vs. 57.5 %, P = 0.003) and neurological symptoms (83.8% vs. 60.0 %, P = 0.002) were more often detected in adult athletes, while respiratory and cardiac symptoms were similar prevalent in both groups.Age ≤ 18 years was independently associated with higher prevalence of asymptomatic SARS-CoV-2-infection (OR 5.12 [95 %CI 1.71–15.33], P = 0.004), but reduced occurrence of cold and flu-like symptoms (OR 0.27 [95 %CI 0.12–0.62], P = 0.002) and of neurological symptoms (OR 0.29 [95 %CI 0.13–0.67], P = 0.003). The included athletes were very rarely affected by adverse events. Pneumonia was detected in one adult athlete (0.9% vs. 0 %). None of the included athletes were afflicted by myocarditis or other serious adverse events. ConclusionsPediatric/adolescent athletes had more often an asymptomatic SARS-CoV-2-infection or were afflicted by only mild symptoms, while adult athletes suffered from larger symptom-burden predominantly driven by neurologic symptoms.

Relevance of the Get Active Questionnaire for Pre-Participation Exercise Screening in the General Population in a Tropical Environment.

The Get Active Questionnaire (GAQ), developed by the Canadian Society for Exercise Professionals (CSEP), was recently recommended for pre-participation screening of the general population in Singapore before increasing their exercise levels. This literature review examines the evidence behind the GAQ and its relevance to our tropical environment. Searches were carried out via Pubmed, MEDLINE and the Cochrane Central Register of Controlled Trials. Resources referenced by the CSEPs were hand searched. The CSEP was also contacted for further information. The evidence behind each GAQ question was compared to international literature and guidelines, where applicable. Out of 273 studies, 49 were suitable for analysis. Two GAQ studies commissioned by the CSEP showed a high negative predictive value but high false negative rate. Of the nine GAQ questions, those on dizziness, joint pains and chronic diseases appear to be justified. Those on heart disease/stroke, hypertension, breathlessness and concussion require modification. The one on syncope can be amalgamated into the dizziness question. The remaining question may be deleted. No long-term studies were available to validate the use of the GAQ. Heat disorders were not considered in the GAQ. Modification of the GAQ, including the inclusion of environmental factors, may make it more suitable for the general population and should be considered.

Considering the Impact of Preparticipation Screening Guidelines on Health Equity for Collegiate Athletes.

Considering the Impact of Preparticipation Screening Guidelines on Health Equity for Collegiate Athletes.

Incidental diagnosis of Coronary Anomaly of the Circumflex Artery with Retroaortic Course by Transthoracic Echocardiography in young athlete

The morphology of human coronary anatomy is fascinating because it is variable. When the morphology deviates from typical anatomy, it is considered anomalous, but this occurs in less than 1% of the population. The left circumflex anomaly is one of the most common congenital anomalies of the coronary arteries, whether it originates from the right coronary sinus (RCS), ergo the right sinus of Valsalva (RSV), or from the proximal right coronary artery and cusp. In this report, the author describes the original case of a 22-year-old healthy male and fit athlete with an anomalous course and origin of the LCX, diagnosed on TTE by the typical RAC during sports pre-participation screening.

Causes of sudden cardiac arrest and death and the diagnostic yield of sport preparticipation screening in children

ObjectiveEvidence on the increased risk of sports-related sudden cardiac arrest and death (SCA/D) and the potential benefit of cardiovascular preparticipation screening (PPS) in children is limited. We assessed the burden...

Prevalence, Performance and Predictors of Electrocardiographic Left Ventricular Hypertrophy in Male Black Athletes: A Retrospective Study

Introduction QRS voltages for electrocardiographic left ventricular hypertrophy (ECG-LVH) are more prominent in Black athletes than non-Black athletes. The underlying physiological relationships of ECG-LVH in BA remain enigmatic despite their greater predisposition to arterial hypertension. Objectives To determine the frequency of eight eponymous ECG-LVH criteria in male collegiate athletes in Nigeria; To determine the diagnostic performance of the most prevalent criteria; To determine the predictors of ECG-LVH. Methods 34 (thirty-four) athletes and 49 (forty-nine) non-athletic controls with normal electrocardiograms and echocardiograms were retrospectively recruited from an existing pre-participation screening cohort. They were all normotensive, non-obese and normoglycemic, and matched for age and body mass index (BMI). Results The four most frequent criteria were Sokolow-Lyon index (67.6% vs. 36.7%; χ2 = 7.7; p = .006), Romhilt’s criterion (52.9% vs. 8.2%; χ2 = 20.6; p < .001), Peguero-Lo Presti criterion (38.2% vs. 22.4%; χ2 = 2.43; p < .144), and Mazzoleni’s criterion (35.3% vs. 4.1%; χ2 = 13.95; p < .001). The sensitivity, specificity and accuracy of these criteria ranged between 23.8%–57.1%, 38.5%–53.9%, and 32.4%–50.0%, respectively. Athletic activity (OR = 4.49; 95% confidence interval, CI = 1.63–12.36; p = .004) and lower BMI (OR = 0.78; 95% CI = 0.63–0.97; p = .026) were independent predictors of ECG-LVH by the Sokolow-Lyon criterion. Conclusions Voltage ECG-LVH criteria all poorly predict the presence of echocardiographic LVH in young male Black athletes. However, the Sokolow-Lyon criterion seems to be associated with a benign cardio-metabolic profile in such athletes and appears hypothetically superior to other voltage criteria for identifying physiological cardiac remodeling in them. This hypothesis should be tested in future studies.

Prevalence and clinical significance of low QRS voltages in healthy individuals, athletes, and patients with cardiomyopathy: implications for sports pre-participation cardiovascular screening.

Low QRS voltages (LQRSV), defined as a QRS amplitude from peak to nadir < 0.5 mV in all limb leads, are an emerging diagnostic finding on the electrocardiogram (ECG). In healthy individuals and athletes, LQRSV are rare (2.2-4% of elite athletes, 0.5% of recreational athletes, and 0.3% of sedentary individuals). LQRSV athletes commonly show ventricular arrhythmias (VAs) on exercise, and up to 40% of those with LQRSV and VAs have late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR). The prevalence of LQRSV in arrhythmogenic cardiomyopathy ranges from 17-40%, predicts left ventricular (LV) involvement, and is correlated with more extensive LGE replacement on CMR. In hypertrophic cardiomyopathy (HCM), LQRSV ranges from 0.7-11%. LQRSV-HCM patients have more segments with LGE, despite relatively smaller LV mass, suggesting a more advanced clinical stage and a worse prognosis. In dilated cardiomyopathy (DCM), LQRSV range from 6-7%, but may be higher (36%) in certain genetic forms of DCM. On a follow-up, LQRSV are independently associated with incident cardiac events, such as sudden death, sustained ventricular arrhythmia, or appropriate internal cardioverter defibrillator discharge. In cardiac amyloid, LQRSV range from 34-66% and demonstrate a negative prognostic value, with worse clinical outcomes regardless of underlying biologic, genetic, and clinical variables. In conclusion, LQRSV deserve careful consideration for exclusion of arrhythmogenic substrates in healthy individuals, athletes, and patients. While additional research is needed, it is reasonable that LQRSV should trigger clinical investigation to exclude underlying diseases at risk of life-threatening arrhythmias.

Ab. No. 178 Comparison of Yo - Yo Intermittent Recovery Test Level 1 In University Level - Cricket and Football Players

Introduction: Cricket and Football are team sports which are intermittent in nature. Furthermore, there are no normative data available for cricketers and footballers specific to Indian Population. Data obtained will be useful for coaches, physiotherapists, sports scientists to determine the fitness level of athletes. The study aimed to evaluate Yo -Yo Intermittent Recovery Test level 1 (YYIRT1) in Cricket and Football Players to obtain age &amp; sex specific baseline data. The study focused on assessing &amp; providing normative values of YYIRT1 and designing training program for cricketers &amp; footballers. Methods: Total 159 participants took part in the study - 51 cricketers, 58 footballers and 50 age-matched control. It is a Cross-sectional study design. Volunteered participants were included in the study based on inclusion criteria. Participants were screened using ACSM – Pre-Participation Screening Questionnaire. Heart rate was recorded using Polar H10. Distance covered in YYIRT1 was used to obtain the predicted Vo2max values. Result: Predicted Vo2max of Cricketers (42.15±1.89), Footballers (42.72±2.31), Age-matched control (38.68±1). Whisker box plot shows, Footballers had equal quartile distribution while cricketers’ quartiles were not equally distributed. Conclusion: This study provides the baseline data of YYIRT1 for cricketers and footballers. Aerobic capacity of football players shows moderately higher vo2max compared with cricketers and age-matched control. Significant difference in vo2max was founded in untrained healthy athletic participants. Implications: Future research should be conducted in different regions of India to bring the normative data for YYIRT1 in Indian population, as the physical and physiological characteristics of different regions can show varied level in Vo2max.

Preventing Sports Injuries: A Review of Evidence-Based Strategies and Interventions

Athletes' inability to return and pursue their athletics is primarily motivated by their fear of re-injury. Sports injuries have been recognized as a significant deterrent to further physical exercise. This study aims to evaluate evidence-based strategies and interventions for preventing sports-related injuries, including pre-participation screenings, suitable training programs, equipment modifications, and injury prevention programs. A systematic review and meta-analysis (PRISMA) approach was used to gather, choose, and analyze publications on preventing sports injuries. Scopus, Web of Science (WoS), ProQuest, and Springer Link were used as databases for the study. The inclusion and exclusion criteria apply to the study.Adequate treatment of sports-related injuries aids in the recovery of injured parts of the body and the prevention of future injuries. Athletes, coaches, and sports medicine specialists can collaborate to reduce the frequency and severity of sports-related injuries, encouraging safer and longer-lasting physical activity participation. Policies that reduce the likelihood of injuries players sustain can be achieved by implementing these evidence-based strategies and interventions into sports training and competition protocols

Sudden Cardiac Death in Adolescent Athletes and the Role of Genetic Screening : A Literature Review

Sudden death, particularly among seemingly healthy individuals, presents a critical challenge in both medical and athletic communities. This literature review investigates sudden cardiac death (SCD) in adolescent athletes, emphasizing the role of genetic screening. Utilizing various studies from 2019 to 2024, the review highlights that SCD, while rare, often stems from cardiovascular issues such as cardiomyopathy and coronary artery anomalies. Pre-participation screening, including ECGs, is crucial in identifying at-risk individuals, yet raises ethical debates regarding athlete disqualification. Genetic factors play a significant role, with inherited heart conditions frequently implicated in SCD cases. Comprehensive genetic screening and family evaluations are vital, although widespread implementation is hindered by limited positive outcomes and potential psychosocial effects. Epidemiological studies reveal a higher incidence of SCD during competitive sports, underscoring the need for tailored prevention strategies. Findings emphasize the importance of multidisciplinary collaboration in enhancing screening methods, risk assessment, and preventive interventions to mitigate sudden mortality in young athletes. The study concludes that lifestyle modifications, promoted by health organizations, and advancements in genetic diagnosis are essential in improving the health and safety of athletes. Efforts to integrate cardiovascular and genetic screening into clinical and athletic practice are paramount, aiming to reduce the incidence of SCD and enhance the well-being of young athletes globally.

A Clinical Case of “Painful” Left Bundle Branch Block in a Female Athlete: “Elective” or Neglected Nosographic Entity?

Painful left bundle branch block is a rarely diagnosed chest pain syndrome. This syndrome is caused by intermittent, frequency-dependent LBBB in the absence of myocardial ischemia. Its prevalence, mechanism, detailed electrocardiographic features and effective treatments are still not well understood. With this case report, the author describes the clinical course of an athlete undergoing competitive sports pre-participation screening that led to the diagnosis of painful left bundle branch block syndrome.

Mexican positioning statement for the preparticipation screening and cardiovascular evaluation in athletes.

Mexican positioning statement for the preparticipation screening and cardiovascular evaluation in athletes.

Electrocardiographic characteristics of pediatric and adolescent football players

Electrocardiographic characteristics of children and adolescents present differences compared to adults. The aim of our work was to study electrocardiograms (ECGs) of football male players from childhood to late adolescence and examine if the ECG parameters are influenced by systematic exercise. One thousand fifty-four football players participated and formed four groups. Group A included 89 players aged 5–7 years, group B 353 players aged 8–11 years, group C consisted of 355 football players 12-15 yearsold and group D of 257 players with 16–18 years of age. All participants underwent preparticipation screening, including 12-lead surface ECG. Heart rate (HR), PR, RR, QRS, QT, QTc intervals, QT dispersion (QTdisp) and QRS axis were calculated. All ECGs were evaluated according to the current preparticipation cardiac screening guidelines, that refer to athletes aged 12–35 years and do not include pediatric players. Eleven percent of the participants presented an ECG finding. Group D obtained the lowest values of HR, QTc and the highest of PR, RR, QRS, QT intervals and QTdisp, whereas no differences in QRS axis were reported. Incomplete Right Bandle Branch Block (RBBB) was the most frequent ECG peculiarity, detected in 7.3% of the participants. Years of training were statistically significantly correlated to HR, PR, RR, QRS and QT intervals. In conclusion, guidelines for ECG interpretation of athletes in childhood, early and late adolescence are needed.

Orthopedic sports injuries: advanced imaging modalities, return-to-play criteria, and injury prevention

Orthopaedic sports injuries encompass a wide range of musculoskeletal conditions resulting from the physical demands of athletic activities. These injuries can vary from acute, such as sprains and fractures, to chronic overuse syndromes like tendinopathies. Prevalent due to the global enthusiasm for sports, they affect bones, muscles, tendons, ligaments, and joints. The etiology of these injuries is multifactorial, stemming from biomechanical stressors, training methods, genetics, and environmental conditions. Advanced imaging modalities like magnetic resonance imaging and Computed tomography have revolutionized the assessment and diagnosis of these injuries, aiding in treatment decisions and return-to-play criteria. Injury prevention is paramount and involves understanding intrinsic (athlete-related) and extrinsic (environmental) risk factors. Strategies include pre-participation screening, strength and conditioning programs, biomechanical analysis, neuromuscular training, proper equipment use, rule changes, education, and creating a safety-conscious culture. Effective prevention reduces the burden of these injuries. Treatment strategies range from conservative approaches to surgery, depending on the type and severity of the injury. Emerging trends in sports medicine, including biologic therapies and telemedicine, offer promising avenues for improved diagnosis and recovery. The holistic approach to orthopaedic sports injuries encompasses prevention, diagnosis, and treatment, ensuring athletes' well-being and longevity in their chosen sports.

Investigating the value of balance and proprioception scores to predict lower limb injuries in professional judokas

We investigated the ability of balance and proprioception screening tests to predict lower limb injuries in professional male judokas. Fifty-three male judokas of the national teams (Mean ± SD, age 18.68 ± 3.08 years, weight 75.34 ± 11.62 kg, height 175.28 ± 7.24 cm) participated in this study. Limits of stability (LOS), single leg stability (SLS), and knee joint position sense (JPS) was recorded as the screening tests before starting the 10 month follow up. Lower limb injury was recorded all through the follow up. Fifteen lower limb sport injuries were recorded for 53 judokas during the follow-up recordings. Significant accuracy of SLS, overall bilateral ratio (AUC 0.646, 95% CI 0.452–0.839, p = 0.046), as well as JPS 60° bilateral ratio (AUC 0.657, 95% CI 0.480–0.834, p = 0.044), and LOS overall (AUC 0.696, 95% CI 0.551–0.840, p = 0.031) were revealed discriminating between injured and uninjured judokas. The optimum cut-off of SLS, overall bilateral ratio, JPS 60° bilateral ratio, and LOS overall associated with belonging to uninjured judokas group was ≤ 1.15%, ≤ 1.09%, and ≤ 1.09 respectively (sensitivity, 0.763, 0.711, 0.789 respectively; specificity, 0.600). Although the absolute unilateral balance and proprioception scores were almost the same between injured and non-injured judokas, the bilateral ratio of both these indices were different between the two groups. Lower limbs bilateral balance and proprioception asymmetries is a more important risk factor than the absolute unilateral balance and proprioception scores for sustaining lower limb injuries in professional male judokas. Medical professionals and coaches are suggested to use these findings as pre-participation screening tools identify injury-prone athletes.

Evaluation of Exercise Mobile Applications for Adults with Cardiovascular Disease Risk Factors.

To conduct a systematic review to determine if there are exercise mobile applications (apps) that can produce evidence-based, individualized exercise plans. We searched the Apple Store and Google Play for exercise apps with terms related to exercise and health. Exercise apps were eligible if they: (1) had a ≥4 out of 5 overall rating with ≥1000 reviews; (2) were free to download; and (3) were not gender specific. Exercise apps were evaluated via the evidence-based exercise prescription (ExRx) standards of the American College of Sports Medicine (ACSM) and American Heart Association. For the exercise app evaluation criteria, an app was included if it (1) was evidence-based; (2) contained a preparticipation health screening protocol; (3) built a cardiovascular disease (CVD) risk factor profile; (4) prioritized one chronic disease or health condition to focus on; (5) framed the exercise plan by the frequency, intensity, time, and type principle (FITT) of ExRx; and (6) specified special considerations. Of the 531 potentially qualifying apps, 219 qualified. The qualifying apps were rarely evidenced-based (0.5%) or had a preparticipation screening protocol (3.7%). Only 27.7% built CVD risk factor profiles. Most apps (64.8%) focused on body image and/or athletic performance. Only 4.3% focused on chronic diseases or health conditions, while the remainder (34.5%) did not disclose a focus. No app framed the exercise plans by the FITT of ExRx. Only 1.4% of the apps specified special considerations. There are no commercially available exercise apps that generate an evidence-based, individualized exercise plan for adults with CVD risk factors.

Burden and causes of sudden cardiac arrest in children: implications for preparticipation screening

Abstract Introduction Competitive sports activity may increase the risk of life-threatening ventricular arrhythmias and sudden cardiac death (SCD) in athletes with underlying cardiovascular diseases (CVD). Preparticipation screening (PPS) offers the potential to early identify CVD and reduce this risk, but the optimal age of sport PPS start is not known. Purpose The aim of this study is to assess the burden of sudden cardiac arrest (SCA) and the diagnostic yield of PPS for CVD at risk of SCA in two different age groups: 8-11 year-old and 12-15 year-old. Methods Data on the incidence and causes of SCA from 2011 to 2020 were retrieved from the sudden death registry of our region, hospital records and local press. During the same period, we assessed 25,251 young competitive athletes aged 8-15 years who underwent 58,185 annual PPS (mean 2.3/athlete) including history, physical examination, ECG and exercise testing. Further tests were required in case of abnormalities at first-line screening. Results Over 10 years, 21 sudden deaths and 5 resuscitated SCA occurred: 6 in athletes (incidence 0.7/100.000/year) versus 20 in non-athletes (0.7/100.000/year). 67% athletes versus 5% non-athletes who suffered SCA were successfully resuscitated (aborted sudden cardiac death=aSCD), (results according to the age-group in Figure 1). Idiopathic ventricular fibrillation was the most common diagnosis accounting for 14/26 (54%) cases. The incidence of SCA was 0.2/100.000/year in the age group 8-11 year-old versus 1.3/100.000/year in the age group 12-15 year-old. By PPS, 26 (0.1%) athletes received a diagnosis of at-risk CVD, significantly more often in children ≥12 year-old (0.06%/evaluation) than &amp;lt;12 year-old (0.02%/evaluation, p=0.02), (Figure 2). During follow-up, 2 screened athletes suffered SCA due to idiopathic ventricular fibrillation, both ≥12 year-old at the time of PPS. Conclusions The incidence of SCA was 6 times higher in the age group 12-15 years compared with the 8-11 years group. Similarly, the diagnostic yield of PPS for at-risk CVD was significantly higher after 12 years of age. This suggests that systematic PPS may not be justified before 12 year-old.Figure 1Figure 2

The role of preparticipation screening in detecting silent coronary artery disease in master athletes: a way to prevent exercise-related adverse cardiovascular events

Abstract Introduction Regular exercise reduces morbidity and mortality from cardiovascular diseases through cardiac and systemic adaptations including the increased coronary blood flow, an improved endothelial function, a slower progression of atherosclerotic processes as well as the stabilization of pre-existing lesions. However, long-term exercise is frequently associated with adverse cardiovascular events in 35-year older subjects because of a cardiac remodeling that predisposes to malignant arrhythmias and to an earlier atherosclerosis. Moreover, in athletes, ischemia is often silent with a higher risk of sudden cardiac death. Purpose The aim of our observational study was to evaluate the efficacy of preparticipation screening in identifying the presence of coronary artery disease (CAD) in a population of asymptomatic master athletes. Methods Between 2018 and 2019, 420 35-year older athletes (mean age: 55 + 17) underwent a preparticipation screening at the University of Pisa. None of them reported cardiovascular risk factors or previous cardiovascular diseases. After a physical examination, all subjects were submitted to spirometry and ECG stress test. Results The ECG stress test demonstrated signs of myocardial ischemia (ST depression &amp;gt; 1 mm) in 41 subjects; 3 athletes showed a frequency-dependent left bundle-branch block; 24 subjects had exercise-induced premature ventricular complexes during the ECG stress test. These subjects underwent further evaluations (Tc-99 myocardial perfusion SPECT and coronary angio-CT) to detect the presence of perfusion defects or coronary abnormalities: 26 athletes had an important coronary atherosclerosis with significant stenosis in one or more vessels and later subjected to Percutaneous transluminal coronary angioplasty (PTCA) or to coronary artery bypass grafting (CABG). 5 athletes presented a coronary myocardial bridge and 1 subject was demonstrated to have an anomalous origin of the left coronary. Conclusions Preparticipation screening in 35-year-older athletes was able to detect the presence of obstructive coronary artery disease (CAD) in the 38% of suspected cases and anomalous origin or intramural coronary course in 8,8% of cases that showed electric abnormalities during the stress test. Despite recent conflicting opinions about the scientific value of the preparticipation screening in young athletes, the present study demonstrated that it was fundamental to early detect silent conditions that could predispose master athletes to adverse cardiovascular events.