pre - participation screening for sporting events

Last reviewed 03/2022

Pre-participation screening for athletes engaging in competitive sport

  • GPs are increasingly asked to complete medicals for sporting events that enable patients to participate in sport

  • although screening is not mandatory by law in the UK, it has become an increasing requirement for some events

  • used appropriately, screening can detect causes of cardiovascular complications (even Sudden Cardiac Death (SCD)) during sport

  • some feel that the cost of widespread screening to detect such abnormalities is prohibitive

  • the level of screening undertaken varies hugely from country to country and from sport to sport. In Italy, a good medical history, physical examination and 12 lead ECG are compulsory by law for participants in competitive sport, with the possibility of echo if indicated

  • Corrado et al (1) have published a consensus statement on pre-participation screening for athletes engaging in competitive sport

  • intensive or prolonged training produces physiological changes that produce a wider range of normal in athletes
    • this can lead to difficulties for a doctor caring for these patients due to difficulty differentiating what is normal in athletes, from what is potentially pathological
    • it can also cause problems for athletes who may receive an inappropriate diagnosis leading to unnecessary investigations and possible withdrawal from the event until clarification of the diagnosis can be sought
    • if further investigations are performed it establishes 'normal' baseline levels for the athlete if new symptoms occur at a later time

Contributors:

  • Dr Andrew Murray, Dr Duncan Goodall
    • Marathon Medical Services
  • Prof Hillis
    • Professor of Cardiology and Exercise Medicine, University of Glasgow

Reference: