Cardiovascular Pre-participation Evaluation of Athletes with an Impairment Recruited for Paris 2024 Paralympic Games

Abstract Introduction Paralympic athletes (PA) represent a special part of the athletic population and deserve a specialized functional and medical care. In view of the 2024 Paris Paralympic Games, a comprehensive sport medical screening was carried out in Italy. This pre-participation medical assessment included clinical, laboratory and instrumental tests including cardiopulmonary exercise test (CPET) and trans thoracic echocardiography (TTE). Aim To assess prevalence and type of cardiovascular abnormalities in PA candidate to compete in 2024 Paralympic Games. Methods We enrolled 167 PA, 80 female and 87 male PA. All of them underwent a comprehensive, multidisciplinary evaluation, including a full panel of blood tests, resting ECG, TTE and CPET. Results 74 PA (44%) showed one or more cardiovascular abnormalities. In details, 12 PA showed abnormal basal ECG findings, 7 abnormal TTE results, 1 uncontrolled hypertension, 30 exercise induced arrhythmias, 8 abnormal basal ECG findings in combination with exercise induced arrhythmias and 7 abnormal basal ECG finding and abnormal echocardiographic findings. Furthermore, 9 PA showed exercise test induced arrhythmias with abnormal echocardiographic findings. Conclusions PA, despite their attitude high levels of performance, are not exempt from cardiovascular and metabolic abnormalities, including a small proportion of cardiac conditions at potential risk of sudden cardiac death. Comprehensive diagnostic tools, including CPET, echocardiography and full blood tests are important to identify hidden cardiovascular abnormalities potentially harmful to the athlete’s health.