Cardiac Evaluation of Collegiate Student Athletes: A Medical and Legal Perspective

Study Questions:

What are the roles of college staff and physicians in establishing optimal, fair, and defensible screening programs and medical supervision for college student athletes?


This manuscript presents a review of important medical and legal considerations for cardiac assessment of college student athletes.


There are several key points to this manuscript: 1) While the screening process is fairly uniform, there is a lack of consensus regarding an optimal screening strategy, particularly in the role for the electrocardiogram; 2) physicians must be aware of common causes of sudden cardiac death in athletes, should obtain an appropriate history and physical exam to identify those at risk, and must be able to distinguish an athletic heart from a structurally abnormal heart; 3) transthoracic echocardiography can identify most cardiac abnormalities that can place athletes at increased risk of sudden cardiac death, 4) colleges and physicians must develop comprehensive and careful procedures to screen students prior to participation in college sports; and 5) physicians and colleges should understand basic legal precedents and expected legal responsibilities in the screening process.


Physicians and colleges screening students for athletic participation must understand how to develop optimal protocols that consider a variety of issues to protect student safety and to fulfill legal responsibilities.


The cardiac evaluation of potential collegiate athletes requires careful collaboration between college staff and physicians to develop fair and rigorous procedures that protect students and address legal responsibilities. Both physicians and college staff must be aware of a range of issues including common causes of sudden cardiac death, optimal methods to screen students, and liability considerations.

Clinical Topics: Arrhythmias and Clinical EP, Noninvasive Imaging, Sports and Exercise Cardiology, SCD/Ventricular Arrhythmias, Echocardiography/Ultrasound, Sports and Exercise and Imaging

Keywords: Physicians, Athletes, Students, Heart, Death, Sudden, Cardiac, Consensus, Echocardiography

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