Cardiovascular screening of adult/senior competitive athletes

Abstract

Regular physical activity at moderate to intense intensity provides substantial health benefits. Therefore individuals should be encouraged to increase their level of physical activity. However, acute bouts of moderate to vigorous exercise may induce cardiovascular (CV) complications, such as malignant arrhythmias and sudden cardiac death/arrest (SCD/SCA), in adults and seniors, mainly due to known or occult cardiovascular disease. The rationale for cardiovascular evaluation and screening is to minimize these dangerous cardiac complications and to ensure safe participation in competitive or leisure-time sports. In individuals engaged in moderate to intense leisure-time physical activities or sporting activities, cardiovascular evaluation should be based on theidentification and severity of the underlying cardiovascular disease. The extent of the evaluation should depend on the intended level of physical activity, the habitual level of exercise and the individual risk profile. Several recommendations for screening, evaluation, and eligibility, given by international societies in Europe and the USA, are discussed. For adult/senior competitive athletes, screening should consist of, at least, personal and familial history (including symptoms), clinical examination, resting ECG, and graded maximal exercise testing, with the last of these mainly in subjects with increased CV risk. Depending on the underlying disease or risk, additional examinations may be required.