AMA Policy Statement on Cardiovascular Screening of Student Athletes

Author: James M. Lyznicki, John F. Schneider
Date: August 15, 2000

In December 1999, the American Medical Association (AMA) Council on Scientific Affairs issued a report on cardiovascular screening of student athletes. This report adds to the American Heart Association's (AHA's) 1996 consensus recommendations for the cardiovascular component of the preparticipation examination of students,(1) and the 1997 guide, "The Preparticipation Physical Evaluation,"(2) sponsored by several major medical organizations, including the American Academy of Family Physicians (AAFP).

The background article for the current AMA report, "Cardiovascular Screening of Student Athletes," is featured in this issue of American Family Physician.(3) The following statements, recommended by the Council on Scientific Affairs, were adopted as AMA policy in December 1999:

1. To promote the health and safety of adolescents, the AMA recommends that state medical societies work with appropriate state and local agencies to promote the following: (A) The development of standards for preparticipation physical examinations (PPEs) that are consistent with consensus recommendations of the AAFP, American Academy of Pediatrics (AAP), American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine and American Osteopathic Academy of Sports Medicine; (B) Only licensed physicians who hold M.D. and D.O. degrees and licensed physician extenders practicing under the supervision of such physicians perform preparticipation examinations; (C) The decision as to whether or not an adolescent is healthy and physically mature enough to participate in a particular sport is made by a qualified physician; (D) The decision as to when an injured athlete resumes participation is made by a qualified physician; and (E) The most current guidelines established by the AAP, American College of Cardiology (ACC), American College of Sports Medicine (ACSM) and other appropriate medical specialty societies are used to determine eligibility for sports participation.

2. The AMA will work with appropriate medical specialty societies to increase awareness among physicians, state and local medical societies, parent-teacher organizations, state legislatures, athletic associations, school administrators and school boards of the availability of consensus medical guidelines and recommendations for sports PPEs.

3. The AMA will submit this report to the Preparticipation Physical Evaluation Task Force requesting that AHA recommendations for (A) family history of heart disease; (B) a specific item for recognition of a heart murmur in the physical examination; and (C) a specific item for recognition of the physical stigmata of Marfan syndrome be considered in future iterations of the PPE form.


(1.) Maron BJ, Thompson PD, Puffer JC, McGrew CA, Strong WB, Douglas PS, et al. Cardiovascular preparticipation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee and Congenital Cardiac Defects Committee, American Heart Association. Circulation 1996;94:850-6 [Addendum appears in Circulation 1998;97:2294].

(2.) Smith DM, American Academy of Family Physicians, Preparticipation Physical Evaluation Task Force. Preparticipation physical evaluation. 2d ed. Minneapolis: Physician and Sportsmedicine, 1997.

(3.) Lyznicki JM, Nielsen NH, Schneider JF. Cardiovascular screening of student athletes. Am Fam Physician 2000;62:765-74.

James M. Lyznicki, M.S., M.P.H., is a senior scientist in the American Medical Association (AMA) Group on Science, Technology, and Public Health, and assistant secretary to the AMA Council on Scientific Affairs.

Nancy H. Nielsen, M.D., PH.D., serves as clinical faculty at the State University of New York at Buffalo School of Medicine and Biomedical Sciences.

John F. Schneider, M.D., PH.D., is in practice at the University of Chicago Hospitals and professor of clinical medicine in the Division of Biological Sciences at the University of Chicago Pritzker School of Medicine.

Address correspondence to Barry Dickinson, Ph.D., Secretary to the Council on Scientific Affairs, American Medical Association, 515 N. State St., Chicago, IL 60610. E-mail address:

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