Best Practice Case Studies-AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes

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The American Medical Society for Sports Medicine (AMSSM) has released a position statement addressing cardiovascular (CV) preparticipation screening in athletes, which aims to detect cardiac conditions that risk sudden cardiac arrest and death (SCA/D). The statement acknowledges the debate on the optimal strategies for CV screening, particularly concerning the inclusion of a resting electrocardiogram (ECG) alongside the standard history and physical examination. Despite the widespread recommendation for CV screening, there is no conclusive evidence supporting a singular or universal approach. The AMSSM does not endorse legislative mandates for a specific screening protocol due to a lack of definitive outcomes-based evidence.<br /><br />The goal of CV screening is early detection of cardiac disorders to reduce risk through medical management. However, due to varying incidence of SCA/D across different athlete demographics, the recommendations suggest that the screening protocol should be tailored according to the specific needs and resources of the athlete population.<br /><br />The task force evaluated the benefits and limitations of history and physical exams, notably their limited sensitivity (around 20%) in detecting conditions that pose an SCA/D risk. The addition of ECG can improve detection rates but comes with challenges including the potential for false positives and the need for accurate ECG interpretation by trained professionals.<br /><br />AMSSM supports the autonomy of physicians to determine the most suitable CV screening strategy based on available evidence, athlete risk, and community resources. They emphasize the importance of emergency action plans and access to automated external defibrillators (AEDs) to manage SCA.<br /><br />Future research should focus on the etiology of SCA/D in athletes, the outcomes of CV disorders detected in screenings, and enhancing both history/physical examination and ECG screening methodologies. The AMSSM remains committed to advancing evidence-based research to establish effective strategies for preventing SCA/D in athletes.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 08

Topic Cardiac

Keywords

3rd Edition, CASE 08

3rd Edition

Cardiac

AMSSM

cardiovascular screening

athletes

sudden cardiac arrest

ECG

screening protocol

cardiac conditions

emergency action plans

evidence-based research

automated external defibrillators