Assessment of the athlete for sports participation

The assessment of the athlete for sports participation remains important as a means to identify those individuals who may have an underlying cardiovascular anomaly that increases their risk for sudden cardiac arrest during practice or competition. The basic requirements for assessment include a thorough history and physical examination. The use of a routine screening electrocardiogram (ECG) and/or echocardiogram remains controversial, though the specificity of ECG screening continues to improve as criteria specific to the athletic population are developed and tested. Given its versatility for screening for multiple structural and electrical cardiovascular anomalies, the ECG is often the first ancillary test performed when concern arises during the initial evaluation. Echocardiography, exercise stress testing, ambulatory ECG monitoring, and chest radiography provide additional diagnostic information when concerning historical or examination findings are uncovered.