July 7 (HealthDay News) -- Including an electrocardiogram in screenings for heart disorders in competitive athletes would improve detection of those at risk for sudden cardiac death and save lives, say Italian researchers.

In the United States, a young competitive athlete dies every three days from an undetected cardiovascular disorder, according to background information in the study. In most of these kinds of cases, the athletes appear healthy and have no previous clinical signs of heart problems.

In the United States and some European countries, authorities have recommended a pre-participation evaluation that includes a detailed family history as well as a physical examination. In Italy, athletes entering competitive sports also must have two electrocardiograms (ECGs), which measure the electrical activity of the heart. One ECG is done while the athlete is at rest, and the other is done while the athlete is exercising.

The use of ECG as part of screening is controversial because of concerns about cost-effectiveness and the number of false positive results.

In this study, researchers at the University of Florence studied the use of ECG in 30,065 athletes who had a complete pre-participation cardiovascular evaluation. During resting ECG, 348 (1.2 percent) of the athletes had distinctly abnormal test results, while 1,459 (4.9 percent) had abnormal results while exercising.

The average age of people with abnormal results only during exercise was 30.9 years, while the average age of those with normal results was 24.9 years.

Of the 159 people who were disqualified from sports due to heart problems, 95 percent would have been missed if only family history and physical examination was used, and 79.2 percent would have been missed if they had only a resting ECG.

ECGs should be added to screening programs for all people taking part in competitive sports, especially those who are middle-aged or older, the researchers said.

The study was published online Thursday in the British Medical Journal.

SOURCE: British Medical Journal, news release, July 4, 2008