(39) Our awareness of this issue, as well as the consideration of preparticipation athletic screening, has been heightened by several high-visibility catastrophies involving elite basketball players who died suddenly and unexpectedly from cardiovascular disease.(38) .
The distinction between athlete's heart and cardiac disease has particularly important implications, because identification of cardiovascular disease in an athlete may be the basis for disqualification from competition in an effort to minimize risk.(40) By the same token, a false positive diagnosis of cardiac disease may lead to unnecessary withdrawal from athletics, thereby depriving that individual of the varied benefits of sport, which may include physical, psychological, and financial benefits of athletic competition. Consequently, interest in the application of noninvasive techniques that may aid in making such a diagnostic distinction and in planning subsequent clinical strategies has increased. The basic goal of a pre-participation cardiovascular screening examination is to identify athletes with unsuspecting heart disease.(28) The extent of the screening continues to be debated, although the American Heart Association, the American Academy of Pediatrics, and the American College of Cardiology have endorsed the following guidelines for the pre-participation cardiovascular screening:.
1. All high school and college athletes should undergo a routine pre participation screening examination.
2. The examination is to be performed by a heath care worker (preferably a licensed physician) who has the medical skills, background, and training to perform a reliable history and physical examination and to recognize heart disease.
3. The evaluation should include a complete medical history and physical examination, including brachial artery blood pressure measurement. .
4. The examination is considered mandatory and should be performed before participation in high school and collegiate sports.
