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AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes: Current evidence, knowledge gaps, recommendations and future directions
  1. Jonathan A Drezner1,
  2. Francis G O'Connor2,
  3. Kimberly G Harmon1,
  4. Karl B Fields3,
  5. Chad A Asplund4,
  6. Irfan M Asif5,
  7. David E Price6,
  8. Robert J Dimeff7,
  9. David T Bernhardt8,
  10. William O Roberts9
  1. 1Department of Family Medicine, University of Washington, Seattle, Washington, USA
  2. 2Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
  3. 3Department of Family Medicine, University of North Carolina, Greensboro, North Carolina, USA
  4. 4Department of Health and Kinesiology, Georgia Southern University, Statesboro, Georgia, USA
  5. 5Department of Family Medicine, University of South Carolina Greenville School of Medicine, Greenville, South Carolina, USA
  6. 6Department of Family Medicine, Carolinas Healthcare System, Charlotte, North Carolina, USA
  7. 7Departments of Orthopedic Surgery, Family and Community Medicine, and Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  8. 8Departments of Pediatrics, Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
  9. 9Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
  1. Correspondence to Dr Jonathan A Drezner, Department of Family Medicine, Center for Sports Cardiology, University of Washington, P.O. Box 354060, Seattle, WA 98195, USA; jdrezner{at}uw.edu

Abstract

Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the centre of the controversy is the addition of a resting ECG to the standard preparticipation evaluation using history and physical examination. The American Medical Society for Sports Medicine (AMSSM) formed a task force to address the current evidence and knowledge gaps regarding preparticipation cardiovascular screening in athletes from the perspective of a primary care sports medicine physician. The absence of definitive outcome-based evidence at this time precludes AMSSM from endorsing any single or universal cardiovascular screening strategy for all athletes, including legislative mandates. This statement presents a new paradigm to assist the individual physician in assessing the most appropriate cardiovascular screening strategy unique to their athlete population, community needs and resources. The decision to implement a cardiovascular screening programme, with or without the addition of ECG, necessitates careful consideration of the risk of SCA/D in the targeted population and the availability of cardiology resources and infrastructure. Importantly, it is the individual physician's assessment in the context of an emerging evidence base that the chosen model for early detection of cardiac disorders in the specific population provides greater benefit than harm. AMSSM is committed to advancing evidenced-based research and educational initiatives that will validate and promote the most efficacious strategies to foster safe sport participation and reduce SCA/D in athletes.

  • Prevention

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Footnotes

  • JAD and FGO cochairs.

  • This article has been co-published in the Clinical Journal of Sport Medicine, and Current Sports Medicine Reports.

  • Twitter Follow Robert Dimeff at @Robert @dimeff

  • Disclaimer The opinions and assertions contained here are private views and are not to be construed as official or as reflecting the views of the Uniformed Services University of the Health Sciences, the US Army Medical Department or the Department of Defense at large.

  • Competing interests None declared. Please see online supplementary appendix 1 for a list of volunteer positions, board and other paffiliations.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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