Preparticipation cardiovascular screening practices in military personnel: results of a European Association of Preventive Cardiology survey

Preparticipation cardiovascular screening (PPCS) is increasingly mandated for athletes who engage in competitive sports.1–3 After years of debate, the transatlantic divide may finally be a thing of the past, with the latest American Sports Cardiology Guidelines now acknowledging that the inclusion of a resting 12-lead ECG is a reasonable component of athlete screening.4 Proposed screening algorithms often include a health questionnaire, physical examination and a resting ECG, adapted to the sporting discipline, level of competition, athlete demographics and cardiovascular risk.1–5 Screening recommendations often overlook individuals in military service whose occupations often demand exceptional levels of physical fitness. Military screening programs are typically broad, designed to ensure a basic level of physical fitness, psychological resilience, and medical suitability across the board. Tailored assessments and skill-focused preparations are often performed later on, once individuals are assigned to particular units or occupational specialities. The ‘tactical athlete’ concept reflects the unique occupational hazards some of these individuals face.6,7 The emerging framework of the tactical athlete underscores the growing need for universal population-specific PPCS guidelines that account for years of service, deployment history and duty role.8