This E-letter is in response to ECG As A Part of the Pre-Participation Screening Programme: An Old an Still Present International Dilemma (Abstract)

Pre-participation screening in competitive athletes in Portugal has been compulsory for more than 40 years. Yearly ECG was introduced in the screening at about the same time as in Italy, for all athletes evaluated at the Sports Medicine Centres in Portugal. The very rare cases of sudden cardiovascular death that have ocurred in the past 25 years in Portugal were not screened at the Centres or had further cardiovascular evaluation pending, and threfore were not qualified for practice. Several athletes have been disqualified from sports participation for cardiovascular reasons, most of them were further investigated because of rest ECG changes findings. We strongly favour the use of 12 lead ECG in the pre- participation screening process. Presently, we routinely screen about 20.000 athletes per year in the 3 Sports Medicine Centres in Portugal.

Marcos A. Miranda
Sports Medicine Specialist
Lisbon Sports Medicine Centre