As Directors of Medical Services to UK Athletics, the English Institute of Sport and the British Olympic Association, we were pleased to receive the Lausanne Recommendations on Preparticipation Cardiovascular Screening for Sudden Cardiovascular Death in Sport.¹ We fully support the goals and motivations behind this document, but having carefully read the document, there are a number of areas that may warrant open discussion. The following dissertation outlines those areas of the recommendations that we, as practising sports physicians charged with their implementation, believe require further delineation and clarity. Our hope is that further discussion will result in enhanced clarity and help on the implementation of these recommendations.

1. We applaud the document’s goals, which are to “identify, as accurately as possible, athletes at risk in order to advise them accordingly”. Although not stated, it is important to be reminded that this is referring to sudden cardiac death in sport and not other causes of sudden death.

2. Despite its goals, it is unclear exactly which sporting group the recommendations are intended for: elite sport, mass participation or the health and fitness industry? This lack of clarity results in interpretation difficulties and makes the subsequent implementation of detail found in the document more uncertain. We believe that this warrants clarification.

3. Although appropriately altruistic in its intent, it is clear that “to …