What EKG findings are most concerning when screening asymptomatic athletes in the outpatient setting?

The first answer is quite simple: anything that fulfills the International/Seattle Wash U/Stanford criteria for further evaluation of young athletes was first proposed in 2011 by Uberoi et al., PMID 21824936, and subsequently modified Drezner et al., PMID 28258178.

From my personal experience, I "light up" for any ST depression in limb leads I or II or in V4, 5 or 6, positive T waves in aVR, any T wave inversion in limb lead I, V3,4,5 or 6, any QRS complex with a duration greater than 130 msec in...

Reading the excellent comments have jarred my brain. Data is accumulating that the most common finding in SCD and SCA in the young is a structurally normal heart most likely associated with LQTS. LQT is probably most commonly missed with screening since it can be dynamic (best diagnosed by ambulatory monitoring and exercise testing) and failure to use Hodges or Fridericia correction rather than Bezett which really fails to adjust for HR. At Stanford, we only use the Fredericia correction and add...

It is best to follow the International criteria for Electrocardiographic interpretation in athletes: Consensus statement. Drezner et al., PMID 28258178. When I do athlete screening, I make sure all the providers and fellows have a copy of it with them to refer to.

• QT interval
• LVH

These are risk factors for SCD.