ECG is a cost effective method for diagnosing cardiac abnormalities in young athletes

August 27, 2012

Cardiovascular screening with ECG in young athletes is a cost effective way of diagnosing cardiac abnormalities, at just 138 Swiss Francs (about €115) per athlete. The findings were presented today, August 26, at the ESC Congress 2012 by Dr Andrea Menafoglio from Switzerland.

Sport is beneficial for health in most people. But for the of the population who has , sport can cause harm and very rarely – in one to three per 100,000 athletes per year – it can lead to .

"The of a professional sportsman in the field, who represents the essence of , has a profound psychological impact in the community and regularly raises the question of how to prevent such a dramatic event," said Dr Menafoglio. "There is debate about which are useful for of young athletes and one of the principal controversies concerns the role of ECG in the screening strategy."

He added: "Solid data indicate that cardiovascular screening including a resting electrocardiogram (ECG) can prevent a substantial proportion of these tragic events, and the European Society of Cardiology (ESC) and major sports associations recommend such a screening programme. However, ECG has been considered by some to have presumed inherent limitations, meaning that subsequent cardiac examinations are required. This substantially raises the costs of a programme that should be implemented at large scale to prevent these relatively rare fatal events.

The study presented at the ESC Congress 2012 assessed the contribution of ECG to diagnosing and the total costs of a programme of cardiovascular screening with ECG in young athletes in Switzerland. The most recent and rigorous criteria for interpreting ECG in athletes were used.

Competitive athletes aged 14-35 years were assessed based on ESC recommendations using personal and family history, physical examination and resting ECG. The ECG was interpreted based on the 2010 ESC recommendations, adapted at some points to take account of evidence accumulated after the recommendations were published. Cardiac examinations were performed by cardiologists or sport physicians with extensive clinical experience. In cases of abnormal findings in history, physical exam or ECG, further examinations were undertaken according to the usual clinical practice. For each athlete, the costs of screening and all subsequent examinations were calculated according to Swiss medical rates.

Between February 2011 and April 2012, 1070 athletes were examined. Mean age was 19.7 years and 75% were males. Football was the most frequent sport (37% of athletes). Athletes trained for a mean of 7.8 hours per week and for a mean of 8.9 years. Most of the athletes (71%) did competitions at regional level.

A total of 6.3% athletes required further examinations: 1.3% due to personal or family history, 1.4% due to and 3.9% due to abnormal ECG. The most frequent subsequent cardiac examinations undertaken were echocardiogram (5.6% of athletes) and exercise stress test (4.0%).

A new cardiac abnormality, previously unknown, was finally established in 2.0% of athletes. The most frequent was ventricular premature beats (0.6% of athletes). In 0.4% of athletes, a cardiac abnormality potentially responsible for sudden cardiac death was established (Wolff-Parkinson-White syndrome and long QT syndrome).

ECG contributed considerably towards establishing a new cardiac diagnosis. Without ECG, a new diagnosis would have been established in 0.8% of athletes, compared to 2.0% with ECG.

The mean cost per athlete of the entire cardiac screening programme was 138 Swiss Francs (about €115).

"Cardiovascular screening with ECG in young is feasible with few subsequent examinations and, accordingly, at low cost, even in Switzerland where the costs of medical services are rather high," said Dr Menafoglio.

"However, cardiac examination and ECG interpretation in is far from easy and requires specific competences," he added. "It is only with considerable experience and applying rigorous ECG criteria that effective can be performed, with few subsequent examinations and low cost, allowing implementation at large scale. Without such experience and criteria there could be an explosion of examinations, costs, anxiety and inappropriate diagnosis."

Explore further: Researchers recommend preparticipation cardiac screening for college athletes

Related Stories

Researchers recommend preparticipation cardiac screening for college athletes

May 26, 2011
Sudden cardiac death in young athletes who had not previously exhibited symptoms is a relatively rare yet tragic event. This occurs in around 60-80 young athletes annually in the United States. In the June 2011 issue of The ...

Cardiac pre-participation screenings too restrictive for black athletes

March 26, 2012
Many athletes undergo cardiac screening to detect possible heart conditions before being allowed to participate in student or professional sports. Current European screening guidelines, which are based on data from white ...

Recommended for you

Low-salt and heart-healthy dash diet as effective as drugs for some adults with high blood pressure

November 22, 2017
A study of more than 400 adults with prehypertension, or stage 1 high blood pressure, found that combining a low-salt diet with the heart-healthy DASH diet substantially lowers systolic blood pressure—the top number in ...

Stroke patients may have more time to get treatment, study finds

November 22, 2017
Patients and doctors long have relied on a simple rule of thumb for seeking care after an ischemic stroke: "Time is brain."

Cases of heart failure continue to rise; poorest people worst affected

November 22, 2017
The number of people being diagnosed with heart failure in the UK continues to rise as a result of demographic changes common to many developed countries, new research by The George Institute for Global Health at the University ...

Some cancer therapies may provide a new way to treat high blood pressure

November 20, 2017
Drugs designed to halt cancer growth may offer a new way to control high blood pressure (hypertension), say Georgetown University Medical Center investigators. The finding could offer a real advance in hypertension treatment ...

Could this protein protect people against coronary artery disease?

November 17, 2017
The buildup of plaque in the heart's arteries is an unfortunate part of aging. But by studying the genetic makeup of people who maintain clear arteries into old age, researchers led by UNC's Jonathan Schisler, PhD, have identified ...

Raising 'good' cholesterol fails to protect against heart disease

November 16, 2017
Raising so-called 'good' cholesterol by blocking a key protein involved in its metabolism does not protect against heart disease or stroke, according to a large genetic study of 150,000 Chinese adults published in the journal ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.