title: Sudden cardiac death in young athletes:  what is the role of screening?
abstract: OBJECTIVE
  To review the recent literature and recommendations for cardiovascular screening in young athletes.
  
  
  RESULTS
  The primary purpose of the preparticipation examination is to detect the cardiovascular disorders known to cause sudden cardiac arrest in the athlete. Studies demonstrate that the traditional history and physical-based examination has a limited sensitivity, does not detect the majority of athletes with at-risk conditions, and may provide false reassurance for athletes with disorders that remain undetected. Electrocardiogram (ECG) screening increases the sensitivity of the examination to detect disease, and cost modeling suggests protocols inclusive of ECG are the only screening strategies to be cost-effective. Proper ECG interpretation that distinguishes physiologic cardiac adaptations in athletes from findings suggestive of underlying cardiac pathology is essential to avoid high false-positive rates.
  
  
  CONCLUSIONS
  The goal of cardiovascular screening is to maximize athlete safety. This includes the detection of underlying cardiac disease associated with sudden cardiac death and reduction of risk through both medical management and activity modification. Greater physician education and research are needed to improve the preparticipation examination in athletes.
authors.affiliation: Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee 37920, USA. iasif@utmck.edu
authors.forename: Irfan M
authors.initials: IM
authors.lastname: Asif
authors.forename: Ashwin L
authors.initials: AL
authors.lastname: Rao
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Drezner
mesh_terms: D000222:Adaptation, Physiological; D056352:Athletes / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis; D003362:Cost-Benefit Analysis; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D042241:Early Diagnosis; D004562:Electrocardiography / Q000379:methods; D005189:False Positive Reactions; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000191:economics / Q000379:methods; D018803:Models, Economic; D010808:Physical Examination / Q000379:methods; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013178:Sports Medicine / Q000191:economics / Q000379:methods; D055815:Young Adult