Sports Medicine| June 01 2008 ECG Screening of Young Athletes for Cardiac Disease AAP Grand Rounds (2008) 19 (6): 63–64. https://doi.org/10.1542/gr.19-6-63 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation ECG Screening of Young Athletes for Cardiac Disease. AAP Grand Rounds June 2008; 19 (6): 63–64. https://doi.org/10.1542/gr.19-6-63 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: athlete, heart diseases, sudden cardiac death Source: Wilson MG, Basavarajaiah S, Whyte GP, et al. Efficacy of personal symptom and family history questionnaires when screening for inherited cardiac pathologies: the role of electrocardiography. Br J Sports Med. 2008;42(3):207–211; doi:10.1136/bjsm.2007.039420 Approximately 80% of non-traumatic sudden deaths in young athletes are caused by inherited or congenital structural and functional cardiovascular abnormalities. This study, from the UK, sought to confirm the efficacy of the resting 12-lead electrocardiogram (ECG) in addition to personal/ family history questionnaires and physical examination as collective screening tools in young elite athletes and physically active adolescents to identify diseases with potential to cause sudden death. All participants were screened using personal and family history questionnaires, physical examination, and resting 12-lead ECG. Athletes with symptoms and/or abnormalities on physical examination and/or ECG abnormalities underwent more detailed cardiac testing. Screening histories and ECGs were interpreted by cardiologists with expertise in sports-related and congenital cardiac disease. In total, 1,074 national and international junior athletes (mean age 15.8 years, range 10–17 years) and 1,646 physically active adolescents (mean 16.1 years, range 14–20 years) were screened. Almost one-third of the elite athlete group reported a family history of heart disease but only 2.9% reported unexplained death or death due to a cardiac etiology among family members. The physically active adolescents showed a higher percentage of positive responses to both questions (35.6% and 9.6% respectively). Overall 4% of participants required further examination because of an abnormal ECG and/or a positive questionnaire. The prevalence of ECG abnormalities was higher in athletes than active teens (2.3% vs 0.9%) as was the diagnosis of cardiac disease (0.5% vs 0.2%). None of the nine participants diagnosed with cardiac disease (three cases of long QT syndrome, four cases of Wolff-Parkinson-White syndrome, one case of arrhythmogenic right ventricular dysplasia, and one case of right ventricular outflow tract abnormality) were symptomatic. No cases of hypertrophic cardiomyopathy were discovered. Overall prevalences of diseases predisposing to sudden cardiac death were 1 in 215 in the elite athletes and 1 in 412 in the school children. The authors conclude that screening history and physical exam are poor predictors of actual cardiac disease and that ECG screening is able to identify more athletes at risk. Dr. Bernhardt has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Pre-participation physical examination screening of young athletes prior to the start of their sport season is commonly practiced around the world. One of the stated goals for this type of screening is to identify conditions which may predispose the athlete to sudden cardiac death. Whether to include an ECG as part of the screening is controversial. Organizations such as the International Olympic Committee and the European Society for Cardiology presently recommend a screening ECG to identify cardiomyopathies and channelopathies which increase the risk of sudden cardiac death during a sport and are silent in terms of symptoms or physical exam findings during the screening process.1... You do not currently have access to this content.