# Addition of Electrocardiogram to Pre-Participation Screening Can Significantly Increase Detection of Cardiac Abnormalities in College Athletes

 

 

      DynaMed Weekly Update - Volume 5, Issue 10 

Conventional cardiac screening for young athletes involves routine history and physical exam. A recent cross-sectional study evaluated the effects of adding electrocardiogram (ECG) to pre-participation screening in 510 college athletes. All athletes also had transthoracic echocardiography (TTE). Of 11 athletes found to have cardiac abnormalities on TTE, 5 abnormalities were detected by conventional screening alone, and 10 were detected with the addition of ECG ([level 3 \[lacking direct\] evidence](http://www.epnet.com/dynamed/levels.php "http://www.epnet.com/dynamed/levels.php")). ECG improved the sensitivity of screening from 45.5% to 90.9% and the negative predictive value from 98.7% to 99.8%. However, ECG was also associated with an increase in false positives from 5.5% to 16.9% ([Ann Intern Med 2010 Mar 2;152(5):269](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=20194232)).

Another study evaluated the cost-effectiveness of adding ECG to the screening of high school and college athletes. ECG was associated with a cost increase of $42,000 per life-year saved, with an estimated saving of 2 life-years per 1,000 athletes screened ([Ann Intern Med 2010 Mar 2;152(5):276](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=20194233)).

For more information, see the [Cardiac arrest](http://search.ebscohost.com/login.aspx?direct=true&site=dynamed&id=116814 "http://search.ebscohost.com/login.aspx?direct=true&site=dynamed&id=116814") topic in DynaMed.