Pre-Participation Cardiac Screening: consideration for Young Athletes

This article is the first of two focusing on the utility and evidence base for pre-participation cardiac screening in competitive athletic populations. The second article will focus on the diagnostic value of different screening modalities used in the large-scale screening of athletic populations. The current article, however, focuses on the incidence of sudden cardiac death (SCD) in young athletic populations and goes on to consider the effectiveness of cardiac screening programmes for reducing the risk of SCD.

Cardiac screening in athletic populations is problematic as it may be difficult to distinguish between physiological adaptations resulting from a specific exercise training stimulus and pathological conditions.

Different types of chronic exercise training can induce eccentric or concentric myocardial hypertrophy, which may mimic pathological conditions. The final section discusses some of the practical issues that a clinician may face when needing to advise a young athlete to either stop or modify his/her habitual patterns of physical activity including future exercise considerations.