Yana Totska¹, Iuliia Padalko¹, Tetiana Tereshchenko¹, Oleg Kasatka^1,

Physically active individuals, including both recreational and professional athletes, are often presumed to be inherently healthy. This assumption can result in minimal or absent cardiovascular evaluation, despite evidence that sudden cardiac events may occur in previously asymptomatic populations. International experience shows a range of screening strategies: Italy implements systematic ECG-based pre-participation screening, with observed reductions in sudden cardiac death among athletes, whereas questionnaire-based approaches in countries including the United States, Canada, and the Czech Republic have shown limited detection of latent cardiac conditions. These observations highlight the need for objective early detection methods that complement traditional evaluations. An ambulatory cardiovascular screening program was conducted among 96 physically active participants without prior complaints or referrals. Each participant completed a questionnaire on demographics, training type, and chronic conditions. Cardiac assessment was performed using an AI-driven digital auscultation device that automatically detected and analyzed heart murmurs. Participants with detected murmurs were referred to cardiologists for further evaluation; not all had completed full diagnostic testing at the time of reporting. Cardiac murmurs were detected in 20 of 96 participants (20.8%; 95% CI: 12.7%–28.9%), including both professional and amateur athletes across various training types. The prevalence did not differ significantly between women and men (24.6% vs 15.4%; p=0.28). None of the affected individuals had a prior diagnosis of structural or valvular heart disease, underscoring the limitations of relying solely on history- and questionnaire-based screening. Even asymptomatic, physically active individuals may harbor latent cardiovascular abnormalities, which are often missed by routine screening approaches. Minimal objective evaluation can improve early detection and preventive care in sports medicine.

cardiovascular screening, heart murmurs, sudden cardiac death, athletes, early detection, sports medicine, AI-assisted auscultation