Sports Medicine: Preparticipation Cardiovascular Screening and Evaluation of Adults

Sudden cardiac death in athletes is a relatively uncommon but devastating event. To prevent such deaths, multiple national and international organizations have created preparticipation evaluation recommendations for cardiovascular screening in adult athletes, care of athletes with cardiovascular disease, and physical examinations. Preparticipation cardiovascular screening of athletes should include the American Heart Association 14-point questionnaire to assess for risk. Exercise stress testing is recommended for athletes with a moderate to high risk of coronary heart disease who want to participate in vigorous athletic activities. Routine preparticipation electrocardiogram is an area of considerable debate, although it does appear to increase early detection of some cardiac disease associated with sudden cardiac disease. An understanding of the basic aspects of initial preparticipation evaluation of adult athletes is essential for family physicians. Recommendations from evidence-based publications and guidelines should be used when available.