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. 2021 Sep 1;31(5):401-406.
doi: 10.1097/JSM.0000000000000798.

Cardiovascular Screening of Elite Athletes by Sporting Organizations in Australia: A Survey of Chief Medical Officers

Jessica J Orchard  1   2 , John W Orchard  2 , Brett Toresdahl  3 , Irfan M Asif  4 , David Hughes  5 , Andre La Gerche  6 , Christopher Semsarian  7
Affiliations

Cardiovascular Screening of Elite Athletes by Sporting Organizations in Australia: A Survey of Chief Medical Officers

Jessica J Orchard et al. Clin J Sport Med. .

Abstract

Objective: To compare cardiovascular screening policies of Australian elite sporting organizations.

Design: Online survey.

Setting: Elite/professional sports in Australia.

Participants: Chief medical officers (CMOs) of elite/professional sports in Australia, including rugby union and league, cricket, tennis, Australian football, and cycling.

Assessment of variables: Survey questions about each sport's cardiac screening policy: which screening components were included [eg, history and physical (H&P), resting 12-lead electrocardiogram (ECG)], whether screening was mandatory, whether the policy applied to elite junior and/or adult players, and which criteria were used to interpret ECGs.

Main outcome measures: Which sports had a formal cardiac screening policy, which athletes the policy applied to, components of screening, ECG interpretation criteria used.

Results: Chief medical officers for 22/31 (71%) sports responded, representing >5000 athletes. Of these, 19/22 (86%) perform regular screening (100% H&P; 89% included ECG) with international cyclists also having routine echocardiograms and stress testing. Thirty-three percent of CMOs used the 2017 International Criteria for athlete ECG interpretation. Screening was mandatory with enforcement (26%), mandatory without enforcement (48%), and opt-out (26%). All screened adult elite athletes, and 68% screened junior elite athletes. Forty-two percent indicated athletes were required to pay for screening tests, and 63% required athletes to pay for follow-up tests. Almost all (94%) sports with a sports physician as the CMO screened athletes.

Conclusions: Most sports have a screening policy, with reasonable uniformity of components. All included H&P, and almost all included ECG. Only one sport included an echocardiogram and stress test as a standard (international players only). Promoting the latest ECG interpretation criteria may reduce false-positives and cost. Future work should explore cardiac emergency plans, screening infrastructure, cost, and long-term follow-up.

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Conflict of interest statement

J. J. Orchard is supported by an Australian Government Research Training Program scholarship. C. Semsarian is supported by an NHMRC Australia Practitioner Fellowship (#1154992). J. W. Orchard is the chief medical officer of Cricket Australia. D. Hughes is the chief medical officer at the Australian Institute of Sport. The remaining authors report no conflicts of interest.

References

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