(July 3, 2008 - Insidermedicine) A cardiovascular screening program for competitive athletes that includes both a resting and exercise electrocardiogram identifies problems that would be missed if the screening did not include ECG, according to research published in the British Medical Journal.

According to the American Heart Association, the physical exam portion of the pre-participating screening of competitive athletes should include evaluation of:

•    Heart murmur

•    Femoral pulses to exclude aortic coarctation

•    Physical stigmata of Marfan syndrome

•    Brachial artery blood pressure (sitting position)

Researchers out of the Institute of Sports Medicine at the University of Florence analyzed data collected from over 30,000 athletes who underwent complete pre-participation cardiovascular screening, including resting and exercise ECG, from 2002 to 2006.

Overall, 1.2% of participants had abnormal findings on resting ECG, but exercise ECG revealed abnormal findings in 4.9% of participants. Those with abnormal exercise ECG findings were more likely to be of older age. Among 159 athletes disqualified based on exercise ECG, 95% would have been missed by history and physical examination, and 80% would have been missed by resting ECG.

Today's research demonstrates how the addition of both resting and exercise ECG to the pre-screening of competitive athletes could save lives. 

For Insidermedicine in Depth, I'm Dr. Susan Sharma.