The beneficial effects of regular physical exercise on cardiovascular morbidity and mortality are well documented. In rare cases, however, athletes with cardiovascular abnormalities are at increased risk of exercise-related sudden cardiac death (SCD). Paradoxically, most SCDs can be attributed to cardiovascular abnormalities that can be identified during an athlete`s life. Such abnormalities can be minimized by several therapeutic strategies, including insertion of an implantable cardioverter-defibrillator. Based on these considerations, the medical and sporting governing bodies recommend preparticipation cardiovascular screening (PPS) in young competitive athletes (aged = 35 years) to identify potentially fatal cardiovascular disorders. However, PPS is associated with several controversies related to the efficacy, cost-effectiveness, and impact of false-positive results. This article aims to provide a detailed overview of the issues concerning PPS based on current evidence.
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