News | Cardiac Diagnostics | September 13, 2016

New Position Statement Evaluates Role of ECG in Athletic Cardiovascular Screening

Statement acknowledges potential benefits of ECG screening but ultimately recommends personalized approach for individual athletes

AMSSM, American Medical Society for Sports Medicine, cardiovascular screening, athletes, position statement

September 13, 2016 — The American Medical Society for Sports Medicine (AMSSM) last week released a new position statement on cardiovascular pre-participation screening for athletes. The statement discusses current evidence and knowledge gaps while offering recommendations and future directions.

AMSSM formed a task force to address the controversial topic of cardiovascular screening in athletes and the potential addition of an electrocardiogram (ECG) to the standard history and physical examination. The position statement presents several new paradigm shifts in thinking about cardiovascular screening in athletes — namely a reassessment of the current standard, recognition of the differential risk of sudden cardiac arrest and death (SCA/D) in different athlete populations, a new framework to assist physicians when considering a screening ECG and respect for physician autonomy to choose the most appropriate screening strategy.

Developed by an expert panel of primary care sports medicine physicians representing all perspectives on cardiovascular screening, the statement provides a balanced assessment of the current evidence and knowledge gaps regarding cardiovascular screening in athletes. The position statement is concurrently being published in the Clinical Journal of Sport Medicine, the British Journal of Sports Medicine and Current Sports Medicine Reports.

The primary goal of cardiovascular screening in competitive athletes is to identify cardiac disorders at elevated risk of SCA/D and to reduce morbidity and mortality through individualized and disease-specific management. The current pre-participation history and physical examination, while pragmatic and widely practiced, is limited in its ability to identify athletes with conditions at risk for SCA/D.

ECG screening does offer enhanced detection of cardiac disorders at potential risk of SCA/D, but it also increases the potential for false-positive results and the associated downstream consequences. “Evidence suggests medical management can reduce the risk of sudden death for several of the cardiac disorders we are looking for. The question is whether we can accomplish early detection and proper management without causing undue harm,” said Jonathan Drezner, M.D., lead author and co-chair of the statement and an AMSSM past president. In choosing a screening strategy, sports medicine physicians should consider the individual risk of the athlete, physician expertise and available cardiology resources for accurate ECG interpretation and the secondary evaluation of ECG abnormalities, as well as their assessment that a particular screening strategy will provide more benefit than harm.

“In the absence of clear evidence, we must respect physician autonomy to implement the most appropriate screening strategy unique to their athlete population and community resources,” stated Fran O’Connor, M.D., MPH, also co-chair of the statement and an AMSSM past president. Widely practiced and accepted screening standards are not perfect and should undergo continual revision as new data emerges.

ECG screening is often framed as a choice between universal, mandatory screening or no screening at all. “A single, universal strategy or ‘one-size-fits-all’ model may not be appropriate for all athletes or all physicians,” Drezner added. Accordingly, AMSSM supports continued research in this area to validate the optimal strategies for reducing SCA/D in athletes.

For more information:,

Related Content

Feature | Cardiac Diagnostics | By Robert L. Quigley, MD, DPhil

Atherosclerotic cardiovascular disease (ASCVD), caused by plaque buildup in arterial walls, is one of the leading causes ...

Home January 23, 2024
News | Cardiac Diagnostics

September 5, 2023 — GE HealthCare announced the launch of a handheld, wireless ultrasound imaging system designed for ...

Home September 05, 2023
Feature | Cardiac Diagnostics | By Kelly Patrick

The global ambulatory diagnostic cardiology market was valued at $2.6 billion in 2022 and is forecast to rise to $3.3 ...

Home May 15, 2023
News | Cardiac Diagnostics

February 8, 2023 — Results of research that identified new causes of Atherosclerotic Coronary Artery Disease, or ASCAD ...

Home February 08, 2023
News | Cardiac Diagnostics

September 15, 2022 - Happitech has announced the launch of its FastStart Research app. The Amsterdam-based digital ...

Home September 15, 2022
Feature | Cardiac Diagnostics | by Kelly Patrick

Like most healthcare markets, the diagnostic cardiology market has had a bumpy ride in recent years. The COVID-19 ...

Home August 23, 2022
Feature | Cardiac Diagnostics | By Adam Saltman, MD, PhD

Before opining on the future of cardiac health, I think it’s important to define what “cardiac health” actually is. If ...

Home May 04, 2022
News | Cardiac Diagnostics

January 31, 2022 — Scientists have developed an artificial intelligence (AI) system that can analyze eye scans taken ...

Home January 31, 2022
News | Cardiac Diagnostics

November 10, 2021 — Abbott released new global market research from its Beyond Intervention initiative, the company’s ...

Home November 10, 2021
Feature | Cardiac Diagnostics | By Dave Fornell, DAIC Editor

October 29, 2021 — A new guideline for the evaluation and diagnosis of chest pain was released this week that provides ...

Home October 29, 2021
Subscribe Now