Preparticipation Screening in Athletes for Prevention of Sudden Cardiac Death

Abstract

Sudden cardiac death (SCD) is a rare event that has become more relevant to the general population over the past several years. There appears to be more prevalence in the media, especially in athletes, which increases patients awareness and stress about the event occurring. Although studies on incidence rates are not readily available over the the past decade, previous past data correlates with increasing rates. Athletic competition is readily available to all patient populations, so it is reasonable to believe that incidence rates of SCD are currently increasing. This raises question on how to decrease future incidence through pre-participation screening (PPS). The purpose of this study was to analyze the efficacy of different screening methods from a statistical, cost-effective, and accessibility viewpoint to best establish a standardized screening protocol in athletes of any age. SCD is most commonly caused by hypertrophic cardiomyopathy, along with other cardiac structural, conductive, and genetic causes. The most common method for PPS is a combination of history and physical exam, with electrocardiogram being used sparingly internationally. Statistical data varies greatly across demographics and athletic skill, leading to difficulty establishing routine PPS worldwide. History and physical exam are cost-effective and simple to conduct, while additional workup including ECG, echocardiogram, stress testing and MRI are often inaccurate, expensive, or inaccessible. Routine follow up with a medical care provider is most beneficial for a patient and/or their guardian because it limits unnecessary testing. Additionally, education on SCD presentation and training in Basic Life Support (BLS) will save lives and decrease the overall incidence