ORLANDO – Although guidelines for assessing the risk of sudden cardiac death in high school athletes were first issued 15 years ago, less than 6% of physicians fully follow those guidelines, according to a survey conducted in Washington State.

Preparticipation physical evaluation is the main mechanism of screening for sudden cardiac death (SCD) in the United States, and is recognized by all national medical organizations, according to Dr. Nicolas Madsen, the survey’s lead author and a pediatric cardiology fellow at Seattle Children’s Hospital and the University of Washington School of Medicine.

The American Heart Association’s (AHA’s) guidelines, issued in 1996 and reaffirmed in 2007, recommend 12 elements for SCD screening of competitive athletes (Circulation 2007;115:1643-55). There are also websites such as ppesportsevaluation.org that provide screening forms for free.

Yet, according to the survey, 47% of physicians and only 6% of high school athletic directors were aware of the guidelines. And although 60% used a screening form, they incorporated only 8 of the 12 recommended elements. Not a single school surveyed was in complete compliance with the AHA guidelines, Dr. Madsen reported at the annual scientific sessions of the American Heart Association.

Lack of compliance with the guidelines was driven mainly by lack of knowledge, and not by location, experience, or physician specialty, said Dr. Madsen.

"New directions for provider education and policy requirements are needed to improve this implementation gap," he and his coauthors wrote.

Dr. Madsen had no disclosures. Dr. G. Paul Matherne (featured in video above) also had no disclosures.