The sudden and unexpected death of an apparently healthy young athlete is relatively uncommon (0.5–2.1/100 000 athletes per year), but the catastrophic nature of these events mandates the medical community to adopt more widespread and extensive preparticipation cardiovascular screening (PPS).1 2

PPS in young athletes (<35 years old) is a systemic method to identify athletes at risk for life-threatening cardiovascular events.3 Excluding these athletes from competitive sports participation leads to a reduction in the incidence of exercise related sudden cardiac death (SCD).3 According to the Italian law all young competitive athletes (about 10% of the population) have been screened in a nationwide screening program in Italy for over 25 years. In the Veneto region in northern Italy, this resulted in a decrease of SCD among young athletes of 89% (from 3.6/100 000 per year in 1979 to 0.4/100 000 athletes per year in 2004).3 This reduction was predominantly attributed to identification of cardiomyopathy and electrical disease, and by excluding these athletes from competitive sports participation. The number of false positive test results was reported at 7%.3

The “Italian experience” is at the moment the only prospective population based study regarding PPS. This Italian protocol was adopted by the European Society of Cardiology (ESC) as the “common European protocol”, and by the International Olympic Committee (IOC), the international soccer association Fédération Internationale de Football Association (FIFA) and the international federation for cyclists Union Cycliste Internationale (UCI) as …