MedWire News: Athletes should be screened for potentially fatal heart disorders before participating in competitions, recommend researchers who say that the widespread adoption of pre-competition heart tests would save lives.

In the USA alone, one competitive athlete dies every 3 days from heart attacks and other cardiovascular disorders and, in most cases, there is no previous clinical sign of heart problems.

Dr Francesco Sofi, from the University of Florence in Italy, and colleagues explain that currently in the USA and Europe, sports authorities recommend that athletes undergo a pre-participation evaluation, which includes a physical examination and assessment of each participant's personal and family medical history.

However, they add that for the past 25 years in Italy, athletes have also been required to undergo two electrocardiograms, which measure the heart's electrical activity, at rest and while exercising before they are allowed to compete.

To assess the effectiveness of this programme, the team analysed data on 30,065 athletes who underwent a complete pre-participation cardiovascular evaluation at the Institute of Sports Medicine in Florence over a 5-year period.

They found that, during the resting electrocardiograms, 1.2% of athletes showed signs of abnormal heart activity. However, results from the electrocardiograms taken during exercise revealed abnormal heart activity in 4.9% of the athletes.

This shows that a significant number of heart problems were only evident during exercise.

Indeed, the team calculated that around 79% of athletes with heart abnormalities would have been missed if they had only undergone a resting electrocardiogram.

Despite the potential costs, Dr Sofi and team conclude that their findings "support the inclusion of resting and exercise electrocardiograms to detect cardiac abnormalities such as [heart rhythm disorders]... and coronary heart disease among people taking part in competitive sports, especially those who are middle aged and older".

They add: "Decreasing the risk of sudden death among competitors is extremely important as it has a considerable impact on both lay and medical communities because of the broadly held view that athletes constitute the healthiest people in society."

The research is published in the British Medical Journal.