In recent years, for the registration of children in activities, the pre-sport test of children has become a prerequisite.

The doctor (pediatrician, pathologist or general practitioner) who has full knowledge of the individual and family history of the child may, after appropriate short training and certification in the interpretation of the electrocardiogram, grant the corresponding certificate, while if pathology is suspected, he will refer the child to the clinical examination for cardiology examination to the specialist.

Each country applies different protocols for the preventive examination of athletes. In Greece, the state has for years made the Athlete Health Card (AHC) mandatory for all athletes. To complete it, a careful history and a clinical examination and an electrocardiogram are required as a minimum. If there are abnormal findings in the above, it is recommended to perform Triplex heart, 24-hour rhythm recording, fatigue test, etc. The Card is valid for one year from the date of its issue and bears a photo of the athlete stamped by the Cardiologist or certified Physician, who keep a copy of the electrocardiogram and any other tests in their file.

Risk of sudden cardiac event

In general, the risk of sudden cardiac death during sports is very small – with about one sudden cardiac death per 100,000 student athletes per year – and clearly much lower than other causes such as traffic or other fatal accidents. In children who do only gentle sports and not championships and have a clear family history, the cardiological examination can be repeated preventively every 3-5 years.
However, it should be pointed out that there are some rare diseases that are not found during the clinical examination, the electrocardiogram or even by the echocardiogram but repeating the tests annually increases the chances of being detected.

Pre-Sports Testing: What Are We Examining?

1) Family history

• Any sudden cardiac death of a relative at a young age (<40 years)
• Heart disease in living relatives
• Hyperlipidemia in first degree relatives

2) Individual history

• Fatigue easily/ Unexplained shortness of breath after exertion
• Fainting/fainting episodes, especially during exercise
• Precardial pain relieved by fatigue
• Palpitations
• Hypertension
• Hyperlipidemia
• Frequent or prolonged hospitalizations

3) Physical examination

• Heart auscultation for heart murmur (supine and sitting) or arrhythmia
• Femoral compressions (to rule out isthmic stenosis of the aorta)
• Points related to various syndromes with cardiac involvement (Marfan, Di George, Turner, etc.)
• Blood pressure measurement (sitting position) and matching to normal values ​​for the child’s body type

4) Electrocardiogram

5) Heart Triplex: Complete anatomical and functional study

As long as the complete cardiological examination is normal, in children doing normal sports activity and not championships, it does not need to be repeated, unless there is a change in the child’s clinical condition.