Heart screening helps identify potential risk factors for SCA in young athletes. It is important to note that not all heart conditions can be detected through screening, and a normal result does not completely eliminate the risk of underlying heart or other medical issues. It is essential that any symptoms including chest pain, shortness of breath, dizziness, palpitations, fainting or unusual fatigue are reported immediately to your regular doctor, regardless of the outcome of any previous screening.
Heart screening explained
This page provides information on initial screening for parents, caregivers, athletes, sporting clubs, groups, schools, organisations, associations and the general public.
Healthcare practitioners can visit the medical community section below for more information.
A number of well-regarded cardiology professional bodies advise cardiac screening as part of pre-participation evaluations for young athletes, including the American College of Cardiology (ACC), American Academy of Paediatrics (AAP), European Society of Cardiology (ESC), American Heart Association (AHA), Association of European Paediatric and Congenital Cardiology (AEPC).
In addition to professional medical bodies, international sports governing bodies recognise the importance of cardiac screening for athletes, including the International Olympic Committee (IOC), Fédération Internationale de Football Association (FIFA), Union of European Football Associations (UEFA), Union Cycliste Internationale (UCI) and International Association of Athletics Federations (IAAF).
To support an effective delivery of our program, screening enrolments are currently being coordinated through community sporting groups, clubs and school sports programs.
Parents, guardians, team managers, coaches and officials are warmly invited to nominate their team members for inclusion on our athlete screening list. We are keen and ready to work with you and your team to support the young athletes in your care through our heart screening program.
Parents, guardians, representatives of community sporting groups, schools and associations can initiate discussions about referring groups of young athletes (aged 12–18) for heart screening by leaving us a message through this link, emailing info@josh4hearts.org.au or by calling 1300 543 278 (1300JHEART).
Initial screening is straightforward and painless. It usually includes:
- An online questionnaire to gather personal and family medical history.
- A heart related physical examination.
- An electrocardiogram (ECG).
It is recommended to start screening from around 12 years of age. If you are already under the care of a specialist or being followed up for an existing heart condition, please note that the outcome of your screening does not replace your existing management plan. You must continue to follow the advice of your regular healthcare practitioner including the use of any recommended medications and follow up plans.
Discover the benefits of screening and learn about Josh-4-Heart Foundation’s model of serial screening. This short video explains how serial screening, supported by current evidence, can help improve outcomes.
We know that talking about heart health can feel worrying – especially for young people. That’s why Josh4Hearts has a youth-friendly environment designed to help young people, parents and care givers feel comfortable and at ease during their visit.
Health history
An important step in initial heart screening is to gather personal and family medical history.
This will include questions on:
- Symptoms like chest pain, dizziness, shortness of breath or fainting during physical exertion
- Any irregular heartbeats or palpitations during physical activity
- Family members with any inherited and/or genetic heart conditions.
This information helps doctors make informed decisions about risk levels in relation to the athlete’s heart health.
Physical examination
Another part of heart screening is a physical examination. The doctor will:
- Check vital signs – this includes things like measuring blood pressure, checking pulse rate and rhythm, measuring height/weight/arm span
- Listen to the heart – the doctor will listen to the heart using a stethoscope.
Electrocardiogram (ECG)
An electrocardiogram (ECG) is an important part of cardiac screening. It is simple and painless. It records the electrical activity of the heart and can help identify many abnormalities in the heart.
The athlete will be asked to lay down. Small sticky monitors (electrodes) will be placed on the chest, arms and legs.
The electrodes are connected to a machine that record the electrical activity of the heart. It’s quick (a few minutes) and painless.
This helps doctors detect abnormalities such as irregular heartbeats and arrhythmias.
What happens after the screening?
After the screening, a cardiologist reviews the results and lets you know within 2 weeks if:
- No further, immediate action is needed, with a routine check recommended in 2–4 years
- Something needs further attention – a follow up appointment is needed which may mean additional tests, such as echocardiogram, Holter monitoring or a stress test, which checks how the heart works during exercise (like running on a treadmill).
Understanding possible outcomes of screening
It’s important for families to understand the benefits, limitations and potential consequences of heart screening so they can make an informed decision.
Occasionally, screening may detect a condition that requires modification of intensity or type of sports. While this can be disappointing, the aim is to protect long-term heart health and help prevent something more serious. Having this information early, even when difficult, is better than a tragedy happening without warning or long term, irreversible damage happening to the heart.
Screening may also identify findings that require further follow-up with your family GP or other specialists outside Josh4Hearts Foundation. If this is the case, you will be advised accordingly and appropriate documentation provided towards continuity of care. Some conditions are only detected through repeat screening over time. Hence, the recommendation for screening to be repeated every 2-4 years.
No screening can identify every possible heart issue, and while serious cardiac events in young athletes are relatively rare, they do occur. Screening reduces risk — it cannot remove it entirely.
Echocardiogram
What an Echocardiogram involves in Cardiac Screening for Athletes
An echocardiogram, also known as an “echo”, is a test that uses sound waves to create a picture of the heart. It helps doctors check the heart’s structure and how well it’s working, including the heart valves and chambers.
The process involves:
1. Preparation
2. Collection
An echocardiogram can help find problems like heart valve issues, abnormal heart chambers, or conditions like hypertrophic cardiomyopathy (a condition that thickens the heart muscle), which can sometimes be found in athletes.
Not every athlete will need an echocardiogram. If required, our doctors will recommend an echo after reviewing the results of the initial assessment, including the medical history, physical exam, and ECG. An echocardiogram will usually be scheduled as a separate appointment.
Exercise Stress Test
An exercise stress test is a heart test that measures how well the heart responds to physical activity. It’s commonly used to check for heart problems that may not show up at rest but could appear during exercise.
Here’s what the process involves:
1. Preparation
2. Collection
What the Exercise Stress Test Can Detect:
An exercise stress test can help identify problems like irregular heart rhythms, heart valve issues, or signs of reduced blood flow to the heart (such as in coronary artery disease).
Not all athletes will need an exercise stress test. If it’s necessary, our doctors will recommend a stress test after reviewing the initial assessment results, including the athlete’s medical history, physical exam, and ECG. If required, a stress test will usually be scheduled as a follow-up appointment.
Holter Monitoring
Holter monitoring is a test that records the heart’s activity continuously over a period of time, usually for 24hrs and beyond. It helps doctors detect irregular heart rhythms or other issues that might not show up during a routine exam or ECG.
Here’s what the process involves:
1. Preparation
2. Collection
The Holter monitor records the heart’s electrical activity while the athlete goes about their normal daily activities, including exercise. The device is small and lightweight, so it can be worn under clothing. The athlete will need to avoid getting it wet (no showering or swimming) and may be asked to keep a diary of their activities and any symptoms they experience.
Holter monitoring can help identify irregular heart rhythms (arrhythmias) or any unusual heart activity that occurs throughout the day or night. It’s particularly useful for issues that may not appear during a short test like an ECG.
Not every athlete will need Holter monitoring. If our doctors think it’s necessary, they will recommend the test after reviewing the initial assessment results, including the athlete’s medical history, physical exam, and ECG. If required, the Holter test will be scheduled for a follow-up appointment.
Medical community
Why screen a healthy athlete?
Cardiac screening for athletes represents good practice. A number of reputable professional cardiology bodies advise cardiac screening as part of pre-participation evaluations for young athletes. These include: American College of Cardiology (ACC), American Academy of Paediatrics (AAP), European Society of Cardiology (ESC) and American Heart Association (AHA), Association of European Paediatric and Congenital Cardiology (AEPC).
In addition to professional medical bodies, international sports governing bodies recognise the importance of cardiac screening for athletes, including the International Olympic Committee (IOC), Fédération Internationale de Football Association (FIFA), Union of European Football Associations (UEFA), Union Cycliste Internationale (UCI) and International Association of Athletics Federations (IAAF).
FIFA published a consensus statement in early 2025 identifying structured cardiac screening for youth football as best practice, with a recommendation to start screening around the age of 12 and repeating screening every 2–4 years until adulthood.
What does screening involve?
A typical athlete screening will be based on international screening recommendation (including medical history, physical examination and a resting 12 lead ECG).
If clinically indicated (based on the findings from History/Examination/ECG), further testing may be performed e.g Echocardiogram, Exercise Stress test, Holter monitoring etc.
After the screening, a cardiologist reviews the results and we let the athlete know within 2 weeks if:
- No further immediate action is needed, with a routine check recommended in 2–4 years
- Something needs further attention – a follow up appointment is needed which may mean additional tests, such as echocardiogram, Holter monitoring or a stress test.
A decision to proceed with any further testing will be solely conditional to the recommendation of our cardiology Team
Possible outcomes of screening
Screening could detect underlying conditions that may result in advise to modify sporting activities or intensity. Whilst this could be protective for physical/heart health, the athlete may require further support from their regular clinician/practitioner.
Screening may pick up findings which will require the athlete’s regular GP to follow up or further specialist tests and interventions that are beyond the scope of what Josh4Hearts Foundation can support. If this is the case, the athlete will be referred to their general practitioner or relevant specialist to co-ordinate further management and future care.
Screening has its limitations. It is impossible to pick up all potential problems with the heart as can be noted in professional, elite athletes who despite rigorous and regular health checks, still experience sudden cardiac arrests.
Educational Videos on Screening
Discover the evidence behind screening and learn about Josh-4-Heart Foundation’s model of serial screening