Cardiac Screening before Participation in Sports
Engl J Med 2013; 369:2049-2053November 21, 2013DOI: 10.1056/NEJMclde1311642
The director of a high school athletic program is considering implementation of a requirement that all student athletes undergo cardiac screening by a physician before participating in any school-sponsored athletic team. Several teachers at the high school have been advocating for a mandatory screening program after seeing a television news report that featured a student from a nearby high school who died from a sudden cardiac arrest while playing basketball. However, coaches have expressed concern to the athletic director that instituting such a requirement would discourage students from playing organized sports and could be a financial burden for some families.
The athletic director seeks your advice on the following two questions:
1. Should young athletes be required to undergo cardiac screening before participating in sports?
2. If an athlete does undergo screening, should the screening involve only a history and physical examination, or should electrocardiography (ECG) also be required?
What do you recommend? To aid in your decision making, four experts in the field defend the possible answers to each of these questions. On the basis of your assessment of the experts' opinions, your reading of published literature, other information sources, and your own clinical experience, make your choices and offer your comments at NEJM.org.
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