title: AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes: Current evidence, knowledge gaps, recommendations and future directions.
abstract: Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the centre of the controversy is the addition of a resting ECG to the standard preparticipation evaluation using history and physical examination. The American Medical Society for Sports Medicine (AMSSM) formed a task force to address the current evidence and knowledge gaps regarding preparticipation cardiovascular screening in athletes from the perspective of a primary care sports medicine physician. The absence of definitive outcome-based evidence at this time precludes AMSSM from endorsing any single or universal cardiovascular screening strategy for all athletes, including legislative mandates. This statement presents a new paradigm to assist the individual physician in assessing the most appropriate cardiovascular screening strategy unique to their athlete population, community needs and resources. The decision to implement a cardiovascular screening programme, with or without the addition of ECG, necessitates careful consideration of the risk of SCA/D in the targeted population and the availability of cardiology resources and infrastructure. Importantly, it is the individual physician's assessment in the context of an emerging evidence base that the chosen model for early detection of cardiac disorders in the specific population provides greater benefit than harm. AMSSM is committed to advancing evidenced-based research and educational initiatives that will validate and promote the most efficacious strategies to foster safe sport participation and reduce SCA/D in athletes.
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Drezner
authors.affiliation: Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Francis G
authors.initials: FG
authors.lastname: O'Connor
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Kimberly G
authors.identifier: http://orcid.org/0000-0002-3670-6609
authors.initials: KG
authors.lastname: Harmon
authors.affiliation: Department of Family Medicine, University of North Carolina, Greensboro, North Carolina, USA.
authors.forename: Karl B
authors.initials: KB
authors.lastname: Fields
authors.affiliation: Department of Health and Kinesiology, Georgia Southern University, Statesboro, Georgia, USA.
authors.forename: Chad A
authors.initials: CA
authors.lastname: Asplund
authors.affiliation: Department of Family Medicine, University of South Carolina Greenville School of Medicine, Greenville, South Carolina, USA.
authors.forename: Irfan M
authors.initials: IM
authors.lastname: Asif
authors.affiliation: Department of Family Medicine, Carolinas Healthcare System, Charlotte, North Carolina, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Price
authors.affiliation: Departments of Orthopedic Surgery, Family and Community Medicine, and Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Dimeff
authors.affiliation: Departments of Pediatrics, Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
authors.forename: David T
authors.initials: DT
authors.lastname: Bernhardt
authors.affiliation: Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: William O
authors.initials: WO
authors.lastname: Roberts
mesh_terms: D026683:Advisory Committees; D056352:Athletes; D002319:Cardiovascular System; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D042241:Early Diagnosis; D006801:Humans; D008403:Mass Screening / Q000592:standards*; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D013177:Sports; D013178:Sports Medicine / Q000592:standards*; D014481:United States
keywords: Prevention