Pre-race screening is about your own safety

Dr Yeo Tee Joo performing an ECG test on marathoner Mok Ying Ren as part of the Sports Cardiology Registry project.
Dr Yeo Tee Joo performing an ECG test on marathoner Mok Ying Ren as part of the Sports Cardiology Registry project.PHOTO: NUH/ONEATHLETE

Pre-participation tests are useful to discover individual cardio risks, limits in training and race exertions

Last year, I explained the importance of pre-participation screening (PPS), in which a combination of blood tests, physical examination, electrocardiogram (ECG) and questions on medical history can help active individuals calculate their cardiovascular risks as well as identify potentially life-threatening heart conditions.


While PPS can be performed on anyone, it is particularly beneficial for sedentary individuals who wish to start training, as well as those with pre-existing heart disease or cardiovascular risk factors.

Based on results of the PPS, a healthcare provider (ideally a sports medicine physician or cardiologist) can then advise on the suitability of the race event you have in mind, and the appropriate duration and intensity of training .


Puzzling as it may sound, fitter active individuals, Asians in particular, also face challenges, but of a different nature, with their ECGs during PPS.

This is because their bodies are conditioned by prolonged periods of training, leading to changes in the electrical system and structure of their hearts.

As a result, their ECGs may look very different from the general population and others who generally lead a more sedentary lifestyle.

To identify normal or training-related ECG features, healthcare providers refer to international recommendations that have taken more than a decade of research to establish and refine.

Unfortunately, these recommendations are based on predominantly Caucasian and African-Caribbean athletes, with minimal Asian representation.


The National University Hospital and Singapore Sports Institute are working together to bridge this knowledge gap by creating a Sports Cardiology Registry of national athletes' ECGs in Singapore.

This collection of localised data will be helpful in determining "normal" baseline indicators for our local population and improve the robust nature of the PPS.

In the long run, these findings can potentially be applied to, and benefit a wider population of recreational athletes.

In spite of the above challenges, the PPS remains an important tool for anyone participating in sports. With a greater nationwide emphasis and enthusiasm towards fitness and active lifestyles, as well as increased participation in endurance events, there is no better time to get yourself screened.

A PPS typically costs between $218 and $1,388, depending on the healthcare provider.

•Dr Yeo Tee Joo is a consultant with the National University Heart Centre, Singapore and part of the multidisciplinary team at the NUH Sports Centre. He is also the lead investigator for the Sports Cardiology Registry project.

A version of this article appeared in the print edition of The Sunday Times on June 10, 2018, with the headline 'Pre-race screening is about your own safety'. Print Edition | Subscribe