Rising Incidence of Cardiovascular Events in Adolescent Athletes: Mandating ECG Testing in Sports Physicals

Hypertrophic cardiomyopathy (HCM)can leadto left ventricular hypertrophy, with stiffening of the myocardium, and eventually results incardiac demand thatexceeds supply. The body overexerts itself and the risk ofsudden cardiac death (SCD) increases due to the inability to compensate.Young student athletes engaging in strenuous physical activity are at greaterrisk for SCD related to non-mandated comprehensive sports screening physicals. The top leading cause of death among student-athletes is cardiac-related, and experts suspect that one high school student will die every three days of sudden cardiac death (NATA, 2023).Electrocardiogram screening is the appropriate diagnostic test to identify this myopathy as it may indicate increased voltage of the QRS complex and inverted T waves in the lateral leads, allowing cardiologists to identify this problem before it results in SCD.Following European guidelines, the proposed policy would be to “recommendthe use of... ECG,” in addition to the preexisting sports physical requirementswhich currently only includes “personal and family history and physicalexamination,” (Han,Lalario,Merro, et al., 2023) in the United States.“Preparticipation cardiac screening” will increase the detection rate of HCM andthus decrease life-threatening cardiac events (Han,Lalario,Merro, et al., 2023).