Athlete Cardiac Screening

Athlete cardiac screening aims to find the few athletes with a hidden heart condition that could cause sudden death in sport, before harm occurs.

In younger athletes the conditions sought are mainly inherited or congenital: hypertrophic cardiomyopathy (HCM), arrhythmogenic cardiomyopathy including arrhythmogenic right ventricular cardiomyopathy (ARVC), channelopathies such as long QT and Brugada syndromes, ventricular pre-excitation, the aortic risk of Marfan syndrome, and coronary artery anomalies. In masters athletes, acquired coronary artery disease becomes the main concern. Screening usually combines a health questionnaire covering personal and family history, a physical examination and a 12-lead electrocardiogram (ECG).

The difficulty is that training changes the ECG in ways that can look abnormal. Athlete-specific criteria separate these adaptations from patterns that signal disease, so healthy athletes are not wrongly stopped and genuine conditions are not missed.