Preparticipation CV Screening: Who Gets the Red Card?

Bernard Gersh, MB, ChB, MD: Hello. I am Dr Bernard Gersh, professor of medicine at Mayo Clinic. During today's Mayo Clinic Heart Talk, we will be discussing the quite contentious issue of sports physicals for children. I am joined by my colleague and our expert in the area, Dr Jonathan Johnson, who is an associate professor of medicine and a pediatric cardiologist at Mayo Clinic. Welcome, Jonathan.

Before we move on to some of the specifics, what are the differences in attitudes about this in the United States compared with some other countries? I know Italy has quite a sophisticated program of regular testing.

Jonathan N. Johnson, MD: The differences around the world are striking. Many countries — Italy was the flag-bearer for many years — and certainly Israel and other countries in Europe now have mandated ECG screening as part of the preparticipation sports physical, in addition to the usual history and physical exam. In the United States and Canada, we have not necessarily mandated ECG, and none of the major cardiology organizations have so far put together any sort of guidelines that support that.

That does not mean that it is not happening in some local areas. There have been studies in