Athletes who take part in competitive sport should be screened for potentially fatal heart problems before they compete, according to a study published on BMJ.com.
The findings show that a pre-participation screening programme, which involves checking the activity of the heart during exercise, would detect more athletes at risk of sudden cardiac death and save lives, say the authors.
One young competitive athlete dies every three days from an unrecognised cardiovascular disorder in the United States alone.
In the majority of cases the athletes appear healthy and there is no previous clinical sign of heart problems. The clinical usefulness of pre-screening programmes to identify people at high risk has been hotly debated. Whether or not to include an electrocardiogram (ECG) as part of pre-screening has been particularly controversial because of concerns over cost-effectiveness and the number of false-positive test results.
In America and Europe authorities have recommended a pre-participation evaluation which includes taking a detailed patient and family history as well as a physical examination.
However, in Italy for the past 25 years, athletes wishing to enter competitive sport have also had to have two ECGs (a test to measure the electrical activity of the heart), one at rest and one while exercising. Researchers from the University of Florence set out to evaluate the clinical usefulness of this programme.
Dr Francesco Sofi and colleagues analysed data from 30 065 athletes who underwent a complete pre-participation cardiovascular evaluation at the Institute of Sports Medicine in Florence during a five year period (2002��).