CME Webinar: Pre-participation Cardiac Screening of Teenage Athletes - Children's National

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.

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