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Cardiovascular incidents in male professional football players with negative preparticipation cardiac screening results: an 8-year follow-up
  1. Hilde Moseby Berge,
  2. Thor Einar Andersen,
  3. Roald Bahr
  1. Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  1. Correspondence to Dr Hilde Moseby Berge, Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo 0806, Norway; HildeMoseby.Berge{at}


Background Preparticipation cardiac screening of athletes aims to detect cardiovascular disease at an early stage to prevent sudden cardiac arrests and deaths. Few studies have described the cardiovascular outcomes in athletes classified as negative on screening.

Objective To identify cardiovascular incidents in a cohort of male professional football players who were cleared to play after a negative screening result.

Methods This is a retrospective 8-year follow-up study of 595 professional male football players in Norway who underwent preparticipation cardiac screening by experienced cardiologists, including electrocardiography (ECG) and echocardiography, in 2008. We performed a media search to identify sudden cardiovascular incidents between January 2008 and February 2016. Incidents were cross-checked with medical records.

Results Six of the 595 players (1%), all classified as negative on cardiac screening, experienced severe cardiovascular incidents during follow-up. Retrospective review revealed abnormal ECG findings in one case, not recognised at the time of screening. Three players suffered a sudden cardiac arrest (all resuscitated successfully), one a myocardial infarction, one a transient ischaemic attack and one atrial flutter. Three of the players ignored chest pain, paresis, dyspnoea or near-syncope, two completed a match with symptoms before seeking medical assistance, one player’s symptoms were misinterpreted and received inappropriate treatment initially, and two players were discharged from hospital without proper follow-up, despite having serious cardiovascular symptoms.

Conclusions A comprehensive preparticipation cardiac screening did not identify a subset of 6 of 595 players who experienced subsequent cardiovascular incidents as being at risk. It is important to remind athletes that a normal cardiac screening exam does not protect against all cardiac diseases. Timely reporting of symptoms is essential.

  • Athlete
  • athlete’s /heart
  • cardiovascular

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  • Contributors HMB designed the study and collected the data, cleaned and analysed the data, collected signatures, and drafted and revised the paper. She is the guarantor. TEA designed the study, collected signatures and revised the paper. RB designed the study, collected signatures and revised the paper.

  • Funding The research reported in this article was supported by the Oslo Sports Trauma Research Center and the Norwegian Olympic Sports Center, Oslo, Norway.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The study was approved by the South-Eastern Regional Committee for Medical and Health Research Ethics.

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

  • Data sharing statement No additional data available.