Cardiovascular preparticipation screening practices of college team physicians

Clin J Sport Med. 2014 Jul;24(4):275-9. doi: 10.1097/JSM.0000000000000067.


Objective: Determine the cardiovascular screening practices of college team physicians.

Design: Cross-sectional survey.

Setting: Electronic mail with a link to a 9-item survey.

Participants: American Medical Society for Sports Medicine college team physicians.

Interventions: Screening practices survey administered to college team physicians.

Main outcome measures: Cardiovascular preparticipation screening practices including noninvasive cardiac screening (NICS) such as electrocardiogram (ECG) or echocardiogram.

Results: Two hundred twenty-four of 613 AMSSM members identifying themselves as college team physicians (36.5%) responded: National Collegiate Athletic Association Division I: 146, Division II: 41, Division III: 27, National Association of Intercollegiate Athletics: 8, and Junior College: 2. The majority (78%) of schools conducted the American Heart Association (AHA) 12-element history and physical examination. Division I institutions were more likely to add an ECG and/or echocardiogram (30%) to their preparticipation examination (PPE) compared with lower divisions (P < 0.0001). Those Division I schools using NICS were more likely to do so for all athletes (P < 0.001) or revenue generating sports (P < 0.001), whereas other institutions did so only for high-risk subgroups (P < 0.01). Lower division schools would consider adding ECG if it cost less (P = 0.01) or if there were more local expertise in athlete-specific interpretation standards (P = 0.04).

Conclusions: Many National Collegiate Athletic Association Athletes Division I programs already use NICS to screen athletes, whereas a significant portion of lower division schools add ECG for athletes deemed high risk. Increased use of these modalities suggests limitations of traditional PPE screening methods.

Clinical relevance: This is the first study to assess cardiac screening practices across all collegiate divisions and broadens our understanding of cardiac screening in high-level athletes.

MeSH terms

  • Cardiovascular Diseases / diagnostic imaging*
  • Cross-Sectional Studies
  • Echocardiography / statistics & numerical data
  • Humans
  • Mass Screening / statistics & numerical data*
  • Sports Medicine / statistics & numerical data*
  • Universities / statistics & numerical data*