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ECG

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There seems to be a lack of consensus among medical associations, professional sports bodies and medical professionals about when pre-participation evaluations (PPE) are indicated and how they should be designed. Although it is generally accepted that the primary purpose of the PPE is the identification of cardiovascular disease and risk factors for sudden cardiac death in competitive athletes, there is an ongoing debate on which methods are most apt in the screening process. Furthermore, the need of PPE has been questioned all together in leisure or hobby athletes.
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Traditionally, cardiovascular screening has been recommended mostly for competitive athletes younger than 35 years. The perception that only young competitive athletes at top level are at increased risk, has changed in the last years. Theoretically, we advocate a voluntary cardiovascular screening for all athletes who exercise vigorously, independent of their competitive status, and age. Although, this should be based on an individual estimation of the athlete’s risk. Physical examination, medical history and an ECG should be the baseline investigations for all athletes.
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During our Annual meeting of the Society for Pediatric Sports Medicine in Basel 2017 one of the highlight sessions was the PRO-CON discussion about the use of a resting ECG as screening tool to detect youth at risk for sudden cardiac death. We present the two statements of the cardiology ­experts that were finally not so controversial as the PRO-CON may suggest. Well as often in medicine, it is the choice of each of you, how to deal with the situation. On one side we are taught to know and listen to the “evidence in medicine”, but on the other side we so often end up in our traditional professional perspective as decision maker that is not always wrong …
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