Outcomes of cardiovascular screening in professional female football players

Yamagata, K, Sivalokanathan, S, Finocchiaro, G, Bhatia, RT, Augustine, D, Bowes, M, Broman, D, Clift, P, Cooper, RM ORCID: 0000-0001-7482-828X, Kenny, A, Mehta, R, Oxborough, D ORCID: 0000-0002-1334-3286, Papadakis, M, Patel, K, Rakhit, D, Ripley, D, Ramcharan, T, Stebbings, GK, Varnava, AM, Walsh, J et al (2026) Outcomes of cardiovascular screening in professional female football players. British Journal of Sports Medicine. ISSN 0306-3674

Preview

Text Outcomes of cardiovascular screening in professional female football players.pdf - Published Version Available under License Creative Commons Attribution Non-commercial. Download (649kB) | Preview

Abstract

Objective To investigate the results of cardiac screening, prevalence of cardiac diseases and subsequent health outcomes among elite female football players in the UK.

Methods Between 2000 and 2024, 3121 elite female football players underwent the English Football Association (FA) cardiac screening programme, comprising a health questionnaire, 12-lead ECG and echocardiogram. The FA registry was interrogated for screening findings, subsequent testing, diagnosis and cardiac morbidity or mortality, including sudden cardiac arrest and death (SCA/SCD). Sex-based comparisons were performed in 2680 females screened between 2017 and 2024, matched 1:2 by age, ethnicity and screening period to 5360 male players screened through the same programme.

Results Female athletes were 19.8±5.4 years old, and the majority (87%) were White. Among 3121 female football players, 193 (6.2%) had an abnormal screening result requiring further evaluation; positive health questionnaires were present in 321 (10.3%), of which two (0.6%) athletes were true-positive for major cardiac conditions. Abnormal ECGs were present in 77 (2.5%), of which four (5.2%) were true positives. Major cardiac conditions were diagnosed in six (0.2%), including four with long QT syndrome, one with Wolff-Parkinson-White syndrome and one with bicuspid aortic valve with moderate to severe aortic regurgitation. No female had cardiomyopathy diagnosed at baseline; however, one (0.03%) was diagnosed with arrhythmogenic cardiomyopathy 18 months later. During 19 193 person-years of follow-up, no female experienced SCA/SCD. In matched analysis, major cardiac conditions were diagnosed in five females (0.2%) and 29 males (0.5%; p=0.027), with higher estimated screening expenditure per major diagnosis in females (£146 809 vs £51 888).

Conclusions Cardiovascular screening in elite female football players identified a low prevalence of major cardiac conditions, predominantly electrical disorders, with no cardiomyopathy diagnosed at baseline and no SCA/SCD during follow-up. As female participation in elite sport continues to grow, these findings support the need for sex-appropriate interpretation and adequate budgeting for pre-participation cardiovascular evaluation.

Item Type:	Article
Uncontrolled Keywords:	Cardiovascular Diseases; Sports medicine; Female; Football; Cardiovascular Diseases; Female; Football; Sports medicine; 32 Biomedical and Clinical Sciences; 3202 Clinical Sciences; 42 Health Sciences; Pediatric Research Initiative; Rare Diseases; Heart Disease; Women's Health; Clinical Research; Congenital Heart Disease; Cardiovascular; 4.2 Evaluation of markers and technologies; Cardiovascular; 3 Good Health and Well Being; 09 Engineering; 11 Medical and Health Sciences; 13 Education; Sport Sciences; 3202 Clinical sciences; 4207 Sports science and exercise; 5201 Applied and developmental psychology
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport and Exercise Sciences
Publisher:	BMJ
Date of acceptance:	22 July 2026
Date of first compliant Open Access:	21 September 2026
Date Deposited:	21 Sep 2026 12:28
Last Modified:	21 Sep 2026 12:28
DOI or ID number:	10.1136/bjsports-2025-111459
URI:	https://researchonline.ljmu.ac.uk/id/eprint/29481

View Item