Athletes should undergo mandatory screening for “silent” heart problems before competing, it has been claimed.
Antonio Pelliccia and Domenico Corrado, writing in this week’s British Medical Journal, said the efficacy of electrocardiographic screening, also known as ECG or heart trace screening, on mortality in athletes has been demonstrated in Italy, which is the only country that requires by law a mass screening programme.
The incidence of sudden deaths after implementation of the programme almost 30 years ago fell by 89 per cent, and no deaths were reported among athletes disqualified from competition because of hypertrophic cardiomyopathy, they write.
They say this supports the idea that timely identification of affected athletes offers the possibility to improve survival.
“Cardiovascular screening for young competitive athletes is justifiable and compelling on ethical, legal, and medical grounds” they argue.
But in an opposing piece, Dr Roald Bahr argues that the diagnostic accuracy of ECG screening varies. Because diagnostic accuracy is low, and depends on which cardiac conditions are the main causes of sudden death, ECG screening for athletes would fail public health criteria.
False positives can be as high as 40 per cent and that some conditions, such as coronary therosclerosis, are likely to remain undetected, he says.
“Screening of hundreds of thousands of athletes to save possibly one life a year, cannot be justified,” he concludes.
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