ECG as a part of the preparticipation screening programme: an old and still present international dilemma.
BACKGROUND
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 is not being routinely practised in other countries.


OBJECTIVE
To evaluate the usefulness of a preparticipation screening programme in a sample of players belonging to different disciplines.


METHODS
From September 2006 to June 2008, 1220 young athletes from different sports disciplines underwent a cardiovascular examination that included personal and family history, physical examination 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 and 75 (6.14%) 12-lead ECG. Echocardiographic assessment fulfilled left ventricular hypertrophy criteria in 8 of the 90 players. Of those, one case was considered an athlete's heart and one case was diagnosed with hypertrophic cardiomyopathy (septal thickness 23 mm). Further tests were needed in the remaining six, included in the "grey area", with one additional case of hypertrophic cardiomyopathy (apical variant) suggested by cardiac MRI.


CONCLUSIONS
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.
Hevia
A Carro
AC
Division of Cardiology, Hospital Universitario, Central de Asturias, Julián Clavería s/n, 33006 Oviedo, Asturias, Spain. achevia@gmail.com
Fernández
M M
MM
Palacio
J M A
JM
Martín
E H
EH
Castro
M G
MG
Reguero
J J Rodríguez
JJ
D000293:Adolescent; D000328:Adult; D042241:Early Diagnosis; D004452:Echocardiography; D004562:Electrocardiography / Q000379:methods*; D005192:Family Health; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008487:Medical History Taking; D010808:Physical Examination; D012017:Referral and Consultation; D013177:Sports; D055815:Young Adult