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Historical and Current Differences Between Europe and the USA in Sports Cardiology

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Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript


Purpose of review

The purpose of this review is to provide an update and discuss the underlying current differences between the European and American approaches to sports cardiology.

Recent findings

Neither approach is monolithic but are nuanced in each country and state. Europe has led the way with cardiovascular screening of athletes. Italy, in particular, has mandated countrywide athlete testing since the 1980s. The American approach, given geographic, financial, and socioeconomic constraints, has been more gradual in development, despite similar goals in reducing exercise-induced sudden cardiac death. These approaches have dovetailed over the last decade through combined efforts to standardize the use of ECG screening with the 2017 International Criteria and more recently with emphasis on shared decision-making. Collectively, despite remaining differences, the common goal has improved the safety of sport participation through reduction in false positives and enhanced international collaboration on the management of cardiovascular conditions in athletes.


While differences remain, close collaboration has led to improved implementation of cardiovascular screening and management of athletes worldwide.

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Correspondence to Mustafa Husaini MD, MBA.

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Dr. Husaini reports Speakers Bureau for Bristol Meyers Squibb. The other authors have nothing to disclose.

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Husaini, M., Pelliccia, A. & Froelicher, V. Historical and Current Differences Between Europe and the USA in Sports Cardiology. Curr Treat Options Cardio Med 25, 629–638 (2023).

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