The majority of young athletes who die suddenly are found to have had undetected heart problems. These rare but tragic events have prompted both the American Heart Association and the Sports Cardiology Study Group of the European Society of Cardiology to recommend screening high school and college athletes before they participate in athletics. Accordingly, a nationwide screening program was launched in Italy in 1982 to identify young athletes (ages 12-35) with potentially lethal cardiac abnormalities. The goal of this program is to prevent sudden death by disqualifying these athletes from participating in competitive sports. The screening included a detailed medical history, a physical examination, and an electrocardiogram .

A new study in the October 4, 2006 Journal of the American Medical Association found that since this program was initiated, the incidence of sudden cardiovascular death in young Italian athletes has declined sharply.

About the Study

Researchers from the University of Padua Medical School in Italy studied the incidence of sudden death in competitive athletes ages 12-35 in the Veneto region of Italy between 1979-2004. They investigated whether the introduction of the Italian screening program was associated with a reduced incidence of sudden cardiac death.

The average rate of sudden cardiac death decreased by 44% from the prescreening (1979-1981) to the early screening period (1982-1992), and by 63% from the early to the late screening period (1993-2004). The incidence of sudden cardiac death in an unscreened non-athletic comparison group was relatively unchanged throughout the study period.

These findings are limited because this was an observational study, meaning that other factors—such as changes in the treatment of cardiovascular conditions over that 25-year period—could have contributed to the decline in the rate of sudden cardiac deaths.

How Does This Affect You?

This study suggests that the Italian screening program may have resulted in a decrease in the incidence of sudden cardiac death among young athletes. A similar program in the United States might also reduce the incidence of sudden cardiac death, but it is not yet clear whether the stringent Italian screening program is superior to the less formal screening program in the United States. And since an estimated 2% of young athletes were excluded from participating in competitive sports, the disadvantages of the screening program—including the disappointment of rejection from competitive sports and the health consequences of not exercising—must be considered. Most of those excluded could have safely participated.

If you are a young athlete or the parent of a young athlete, talk to your doctor about the risk of sudden cardiac death. If your family or personal medical history indicates that you are at risk of having an undetected heart problem, a few simple tests (electrocardiogram and echocardiogram ) can usually identify potentially dangerous cardiac abnormalities.