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ECG As A Part of the Pre-Participation Screening Programme: An Old an Still Present International Dilemma
  1. Amelia Carro Hevia1,*,
  2. Maria Martin Fernández1,
  3. Jose Manuel Ania Palacio2,
  4. Ernesto Hernandez Martín3,
  5. Monica García Castro4,
  6. Jose Julián Rodriguez Reguero1
  1. 1 Hospital Universitario Central de Asturias, Spain;
  2. 2 School of Sports Medicine, Faculty of Medicine, University of Oviedo, Spain;
  3. 3 Hospital de Cabueñes, Asturias, Spain;
  4. 4 Division of Genetics, Hospital Universitario Central de Asturias., Spain
  1. Correspondence to: Amelia Carro, Cardiology, Hospital Universitario Central de Asturias, Julian Claveria s/n, Oviedo, 33006, Spain; achevia{at}


Introduction: Long term Italian experience has provided evidence that preparticipation screening in competitive athletes with 12-lead ECG, history and physical examination, is effective in identifying potentially lethal cardiovascular diseases. However, it’s not being routinely practised in other countries.

Objectives: Evaluate the usefulness of a preparticipation screening programme in a sample of players belonging to different disciplines.

Material and methods: From September 2006 to June 2008, 1220 young athletes from different sports disciplines underwent a cardiovascular examination which included personal and family history, physical exam and a resting 12-lead ECG. Those with abnormal findings were referred for additional tests.

Results: 1220 athletes were screened: 96% males; mean age 23±4 years. 90 (7,4%) players were referred for additional tests because of abnormal findings on baseline examination: 11 (0,9%) personal or family history; 4 (0,08%) physical examination; 75 (6,14%) 12-lead ECG. Echocardiographic assessment fulfilled left ventricular hypertrophy criteria in 8 out of the 90 players. Of those, one case was considered an athlete’s heart and one case was diagnosed of hypertrophic cardiomyopathy (HCM; septal thickness 23 mm). Further tests were needed in the remaining six, included in the “gray area”, with one additional case of HCM (apical variant) suggested by cardiac magnetic resonance imaging.

Conclusion: Given the ability of 12-lead ECG to detect individuals with structural heart disease, we suggest its inclusion as a part of preparticipation screening programmes.

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