AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes : Current Evidence, Knowledge Gaps, Recommendations, and Future Directions
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Abstract
Cardiovascular (CV) screening in young athletes is widely recommended and routinely
performed before 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 CV screening in athletes
remains an issue of considerable debate. At the center of the controversy is the addition
of a resting electrocardiogram (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 CV screening in athletes from the perspective of a primary care sports
medicine physician. The absence of definitive outcomes-based evidence at this time
precludes AMSSM from endorsing any single or universal CV screening strategy for all
athletes including legislative mandates. This statement presents a new paradigm to
assist the individual physician in assessing the most appropriate CV screening strategy
unique to their athlete population, community needs, and resources. The decision to
implement a CV screening program, 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. American Medical Society for Sports Medicine 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.
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