Assessment of cardiovascular risk among school athletes: A retrospective cross-sectional study

Objectives Globally, undiagnosed cardiovascular anomalies are the primary cause of sudden cardiac deaths among school athletes. In Sri Lanka, data on this subject remain scarce. Recent fatalities involving adolescent athletes have highlighted the need for preventive measures to be introduced by the country’s healthcare sector. The aims and objectives of the study are to determine the prevalence and contributing factors for cardiovascular pathologies found in school athletes as well as the associated cardiovascular risks of competing in other major competitive sports. Materials and Methods A retrospective cross-sectional study was conducted at a sports medicine clinic in a tertiary care hospital, focusing on school athletes aged 10-19 years undergoing medical clearance for endurance sports. The study spanned 18 months, from January 1, 2022, to June 30, 2023, with a computed sample size of 784 athletes. Preliminary testing led to adjustments in the data collection sheet. Secondary data were retrieved by sports medicine physicians from archived pre-participation health clearance questionnaires. Results Among the participants, 118 individuals (15.1%) were aged 10-12 years, 164 (20.9%) were 13-15 years, and 502 (64%) were 16-19 years. The prevalence of electrocardiogram (ECG) abnormalities was estimated at 5.6%. The relative risk of detecting an ECG abnormality in the 10-12 age group compared to those aged 13 years and above was 6.773 (confidence interval [CI] 3.868-11.859), with an odds ratio of 8.247 (CI 4.385-15.509). Similarly, comparing the 16-19 age group ( n = 502) to the combined 10-15 age groups ( n = 282) revealed a relative risk of 5.340 (CI 2.742-10.401) and an odds ratio of 5.916 (CI 2.940-11.903). It can be concluded that the younger participants have a relatively higher incidence of ECG abnormalities compared to older age groups. The study found a 3% prevalence of cardiovascular anomalies among adolescent athletes in Sri Lanka. The mitral valve prolapses are the most common followed by mitral stenosis, ventricular septal defect, and the least being aortic stenosis. Conclusion Screening athletes with a thorough medical history and detailed clinical examination effectively uncovers hidden cardiovascular conditions and serves as a reliable method to identify potential risks. Adding an ECG improves the sensitivity of detecting rare or asymptomatic issues, while the selective use of 2-D echocardiography further enhances diagnostic accuracy.