ECGs as part of athlete screenings less favored in U.S.

Although a majority of medical experts recently polled believe young athletes should be screened for cardiac disease before participating in sports, less than half of providers in the U.S. say electrocardiograms (ECGs) should be included, according to an article published March 6 in the New England Journal of Medicine. The majority of their European counterparts, on the other hand, do favor ECGs as part of the process.

James A. Colbert, MD, of Brigham and Women’s Hospital in Boston, discussed the poll, conducted at the annual meeting of the American Heart Association (AHA) in November. Audience members were presented with the case of a high school athletic director who needed advice on whether to require cardiac screening of athletes. Four physicians then presented their opinions. Afterward, audience members at the AHA session voted and in addition, the same case and physician opinions were presented on the website and readers were invited to vote and post comments. 

Of the live voters at the AHA, 70 percent favored screening and 60 percent believed screening should include ECGs. Online, there were 1,266 votes from 86 countries, and of those voters, 18 percent were against screening young athletes for cardiac disease, 24 percent favored screening with only a history and physical examination, and 58 percent favored screening that included history, physical examination and ECG.

However, screening with ECGs was favored more outside the U.S.—only 45 percent of U.S. voters were in favor of ECGs as part of the screening process compared with 66 percent of voters in Europe. Nearly 75 percent of voters in Italy voted in favor of ECGs as part of the screening process. Only 13 percent of European respondents favored screening with only a history and physical examination compared with 35 percent of respondents in the U.S.

Colbert noted that the American Academy of Family Physicians does not support widespread use of ECGs in screening of young athletes and the European Society of Cardiology does. In the end, it will be up to the medical community, legislators and the public to decide whether spending limited funds on athlete screening is warranted over other public health priorities.