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Discussion
Cardiac screening of athletes: consensus needed for clinicians on indications for follow-up echocardiography testing
  1. Jessica J Orchard1,
  2. John W Orchard1,
  3. Andre La Gerche2,3,
  4. Christopher Semsarian1,4
  1. 1 Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
  2. 2 Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
  3. 3 St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
  4. 4 Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, New South Wales, Australia
  1. Correspondence to Professor Christopher Semsarian, Centenary Institute, Locked Bag 6, Newtown, NSW 2042, Australia; c.semsarian{at}centenary.org.au

https://doi.org/10.1136/bjsports-2019-101916

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    Many sporting teams, leagues and federations now mandate cardiac screening of athletes. The most common screening protocol in Australian sports involves a personal/family history and physical examination, together with a resting 12-lead ECG.1 Some bodies, such as the Union Cycliste Internationale, the England and Wales Cricket Board and the UK Football Association also mandate two-dimensional transthoracic echocardiography as part of the standard screen. While echocardiography is sometimes used as a screening tool, the variable use of this modality in cardiac screening programmes raises the issue of when this test should be used as a diagnostic tool for the follow-up evaluation of other screening abnormalities. There is a need for clear consensus guidance, which should take into account the additional costs, as well as the potential benefits of echocardiography and the potential harms of incidental findings.

    We audited the national cardiac screening programme of elite men’s and women’s Australian cricket.2 The protocol consists of history, physical examination and ECG. Overall, 2.0% of ECGs were abnormal or had ≥2 borderline findings according to the international criteria for athlete ECG interpretation,3 although 5.5% of cases had an echocardiogram, which …

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    Footnotes

    • Twitter @jessicajorchard, @DrJohnOrchard, @CSHeartResearch

    • Contributors All authors contributed to drafting and finalising the Discussion piece.

    • Funding This study was funded by National Health and Medical Research Council (grant no: 1154992) and Australian Government Research Training Program.

    • Patient consent for publication Not required.

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