Pre Health Screening

Journal of the American College of Cardiology
© 2008 by the American College of Cardiology Foundation
Published by Elsevier Inc.

Vol. 52, No. 24, 2008
ISSN 0735-1097/08/$34.00

Screening of Athletes

Pre-Participation Screening of Young Competitive
Athletes for Prevention of Sudden Cardiac Death
Domenico Corrado, MD, PHD,* Cristina Basso, MD, PHD,† Maurizio Schiavon, MD,‡
Antonio Pelliccia, MD,§ Gaetano Thiene, MD†
Padua and Rome, Italy
In 1982 a nationwide program of pre-participation screening including 12-lead electrocardiography (ECG) was
launched in Italy. The aim of this article is to examine whether this 25-year screening program should be considered a valid and advisable public health strategy. The analysis of data coming from the long-running Italian experience indicates that ECG screening has provided adequate sensitivity and specificity for detection of potentially lethal cardiomyopathy or arrhythmias and has led to substantial reduction of mortality of young
competitive athletes by approximately 90%. Screening was feasible thanks to the Italian Health System, which
is developed in terms of health care and prevention services, and because of the limited costs of cardiovascular
evaluation in the setting of a mass program. On the basis of current scientific evidence the implementation of a
mass-screening program aimed to prevent athletic-field sudden cardiac death should be at least carefully considered by public health administrators worldwide. (J Am Coll Cardiol 2008;52:1981–9) © 2008 by the American
College of Cardiology Foundation

“He who saves a single life saves the whole world.”
—Talmud Sanhedrin 4:5 (1)

Sudden death during sports is often the first and definitive
manifestation of an underlying cardiovascular disease, which
usually has a silent clinical course (2– 6). Medical evaluation
before competition offers the potential to detect still asymptomatic athletes with life-threatening heart...