Avoidance of Sport and Race-Specific Cardiac Screening of Athletes: A Statement from the ACC Sports and Exercise Cardiology Leadership Council

The views and opinions expressed are those of the American College of Cardiology (ACC) Sports and Exercise Cardiology Council and are not official clinical policy from the ACC.

Recent cases of sudden cardiac arrest (SCA) among high-profile competitive athletes have brought appropriate attention to emergency cardiac care for athletes. While sudden cardiac death in young athletes is rare overall, some epidemiological data suggest that self-identified Black athletes face a higher risk compared to White athletes, with basketball potentially being a particularly high-risk sport. Consequently, there has been suggestion that 'higher risk' athletes, particularly self-identified Black basketball players, should undergo more extensive cardiac screening prior to sports participation.

Given its clear association with SCA risk, it is tempting to use self-identified race as a marker to better target screening efforts toward athletes at greatest risk. However, current scientific evidence does not support this approach. Despite Black athletes' higher risk of SCA, the cause is unknown; the high-risk conditions that screening tests are intended to identify are not found more commonly among Black athletes. Coupled with the negative consequences of ambiguous screening results and the potential to promote health care stigmas about race, there is potential for targeted screening to actually harm the athletes it was intended to help. Further research aimed at understanding and effectively preventing SCA among high-risk athletes such as Black basketball players should be an urgent focus of future research.

Clinical Topics: Arrhythmias and Clinical EP, Sports and Exercise Cardiology, Implantable Devices, SCD/Ventricular Arrhythmias

Keywords: Sports, Sports Medicine, Athletes, African Americans, Death, Sudden, Cardiac, Heart Arrest

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