During a pre-participation examination (PPE), how effective is an electrocardiogram in predicting future cardiac events?

An electrocardiogram (ECG) is a valuable tool in the assessment of cardiac health during a pre-participation examination (PPE), but its ability to predict future cardiac events is limited. While an ECG can identify existing abnormalities, such as arrhythmias or signs of hypertrophy, its predictive value for future events, especially in asymptomatic athletes, is not as strong.

The limitations lie in the fact that many cardiovascular conditions may not manifest on an ECG until significant symptoms arise. As a result, the ECG may not effectively detect all potential cardiac issues, particularly in younger athletes who are generally at a lower risk for serious cardiac events. Hence, the conclusion that an ECG is not likely to detect future events aligns with the research surrounding its use and effectiveness in this context.

While other methods such as family history assessments, exercise stress tests, and additional cardiovascular evaluations can provide more comprehensive screening, the ECG by itself does not consistently predict future cardiovascular events in a population of asymptomatic individuals.