CME Webinar: Pre-participation Cardiac Screening of Teenage Athletes: Goals, Challenges and Pitfalls

In this webinar, Jared Hershenson, M.D., pediatric cardiologist and medical director of Cardiac Exercise and Rehabilitation at Children’s National Hospital, discussed the importance, methods, challenges and recommendations of pre-participation cardiac screening, as well as secondary prevention and eligibility recommendations for athletes with known congenital heart disease.

Key takeaways

• Importance of cardiac screening: Although sudden cardiac death in young athletes is rare, its impact is devastating, and screening aims to prevent such occurrences.
• Causes of sudden cardiac death: Key causes include arrhythmia syndromes, cardiomyopathies, congenital coronary abnormalities and other undiagnosed congenital heart diseases.
• Screening methods: Screening involves history and physical exams, with forms based on AHA and AAP guidelines, and may include ECGs and other tests, although these methods have limitations.
• Challenges in screening: The sensitivity and specificity of pre-participation exams are low, and there is a lack of uniformity in how screenings are conducted, leading to potential false positives and negatives.
• Debate on ECG screening: While ECG screening can improve sensitivity and specificity, it also has issues like false positives, which can lead to unnecessary anxiety and additional testing.
• Secondary prevention: Secondary prevention focuses on having emergency action plans and AEDs in schools to manage sudden cardiac arrest effectively, reducing the risk of death and complications.
• Eligibility recommendations: Guidelines for athletes with congenital heart disease emphasize individualized assessments to determine safe participation in sports, but there is a need to shift the focus to promoting physical activity rather than restricting given the long-term benefits of exercise and the low risk of sudden cardiac events.
• Shared decision making: Shared decision making involves discussing the benefits and risks of sports participation with patients and their families, ensuring informed decisions about participation in physical activities.

More information

• For more information on this webinar, as well as access to the presentation slide deck, visit our website.
• To register for future CME opportunities or view past presentations, visit childrensnational.org/Webinars.