Pre-participation evaluation for athletes

The data pertaining to the incidence of sudden cardiac death (SCD) in young athletes are equivocal but in the region of 1 in 14,000 to 1 in 100,000 with a 5 to 10 times higher risk in master athletes. Cardiac pre-participation evaluation (PPE) has become an important tool in reducing the risk of SCD by identifying underlying disease and allowing for individualised risk management strategies. There is general agreement for the use of PPE as a means of identifying those athletes at risk of SCD; however, the specific protocol that is implemented can vary across sporting organisations and countries. Evidence suggests that masters-class athletes have a higher prevalence of CAD than non-athletes and therefore may be at higher risk of SCD. Although athletes are overtly ‘healthy’, there is a small but significant risk of SCD in this population, and PPE is fundamental in identifying those individuals at risk.