athlete pre-participation cardiac screening

More than 90% of sudden deaths during exercise/sport are related to pre-existing cardiovascular problems. These deaths are classified as “sudden cardiac death”. According to the European Society of Cardiology an athlete pre-participation examination may decrease sudden cardiac death by up to 89%. 

The International Triathlon Union, in their website,  describe the purpose of this assessment as “to identify, as accurately as possible, athletes at risk in order to advise them accordingly”.

We need to highlight that no screening process is 100% infallible. Screening may yield false positive or false negative results. A false positive result is where an abnormality has been detected when no abnormality exists. A false negative result is where no abnormality has been detected when an abnormality exists.  By using 3-step testing and the application of current international recommendations for the interpretation of ECGs in athletes, we aim to reduce the number of false positive and false negative results (without ever being able to reduce these to zero).

Preventive cardiac screening of athletes aims to offer early identification of underlying conditions which may cause serious incidents during exercise/training/competition. In individuals up to 35yrs the focus is on inherited conditions which the athlete may be harbouring. For the over 35s we are also concerned about acquired cardiovascular conditions and this is reflected in the additional assessments of cardiovascular disease risk factors (e.g. blood lipids and blood sugar) and (if indicated) the assessment of an ECG during a maximal exercise test. 

If a test result is positive (or equivocal) we will advise on the recommended follow-up and give you a referral letter to take to your own medical practitioner (GP or cardiologist). If your result is negative, we will offer proof of that to use for sports where such clearance is mandated.

The service we offer was designed based on current recommendations of the European Society or Cardiology and the European Association of Preventive Cardiology. 

For persons up to the age of 35yrs the screening involves:

1. Personal and Family Medical History Questionnaire (to be completed online prior to your assessment)
2. Physical Examination by a medical doctor; including heart sounds, peripheral pulses, heart rate and blood pressure
3. The assessment of a resting 12-lead electrocardiogram (ECG) based on current recommendations for the assessment of athletes’ ECGs

There is a form that needs to be completed and submitted online prior to your appointment - this will take around 15 minutes. The appointment with the doctor and physiologist is approximately 30 minutes long.

For persons over 35yrs screening involves all the above plus:

• Assessment of cardiovascular disease risk using appropriate risk calculators as recommended by the European Society of Cardiology. (This will add 15 minutes to your appointment).

In some cases a maximal exercise test with ECG and gas analysis (known as Cardiopulmonary Exercise Test – CPET) may be recommended. (This will add 40 minutes to your appointment).

At the end of the assessment, you will be able to take a copy of your ECG away with you. If no pre-existing cardiovascular problems are identified on the day, then you will be provided with a signed letter by the Doctor confirming your eligibility to compete. If any problems are identified on the day, you will be advised about how to obtain additional assessment.

Regular, preventive cardiac screening is recommended for anyone training for competitive sport – at any level and those who engage in serious training even if they do not take part in competition.

1. Under 35s screening is £168
2. Over 35s screening is £193
3. CPET (when required or elected as an add-on to the above) is £220
4. Full package for cardiac screening (screening + CPET) is £400