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manner. This usually includes most part, a standard of care and are
guidance from a cardiologist. generally accepted—at least at the
collegiate level — by most physicians
Legal Aspects providing preparticipation cardiac
exams to athletes.
The medical legal aspects regarding
the preparticipation cardiac exam Conclusion
are a concern of many physicians.
However, a physician who has Sudden cardiac deaths in athletes take
cleared an athlete to compete should place infrequently but are quite devas-
not be held liable for an injury or tating when they occur. Although
death caused by an undiscovered the guidelines for preparticipation
cardiac condition. Malpractice cardiovascular exam established by
requires proof that (1) the physician the AHA were not intended to become
deviated from customary or accepted a medical/legal standard, they have
medical practice of their specialty in been widely accepted by the medical
performing preparticipation screening community. These guidelines provide
of athletes and (2) the use of estab- a foundation for future preparticipa-
lished diagnostic criteria and methods tion cardiac screening and are,
would have disclosed the medical currently, the best recommendations
abnormality.1 The above mentioned available to identify athletes at risk
guidelines4 have become, for the for sudden cardiac death.

References

1. Maron BJ, Thompson PD, Puffer JC, et al. Cardiovascular pre-participation screening of competitive athletes. Circulation.
1996. 94:850–856.

2. Huston TP, Puffer JC, Rodney WM. The athletic heart syndrome. N Eng J Med. 1995. 313:24–32.
3. Maron BJ, Thompson PD, Puffer JC, et al. Cardiovascular pre-participation screening of competitive athletes: addendum.

Circulation. 1998. 97:2294.
4. American Academy of Family Physicians, American Academy of Pediatrics, American Medical Society for Sports Medicine,

American Orthopaedic Society for Sports Medicine, American Osteopathic Academy of Sports Medicine. Preparticipation
Physical Evaluation, Second Edition. The Physician and Sportsmedicine: Minneapolis, MN. 1997.
5. Kurowski K, Chandran S. The pre-participation athletic evaluation. Am Fam Phys. 2000. 61:2683–2690.

© AMERICAN ORTHOPAEDIC SOCIETY FOR SPORTS MEDICINE, 2008, ALL RIGHTS RESERVED

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