Pre-Athletic & Pre-School Cardiological Check-Up
Medically reviewed by: Dr. Theodoros Barlogiannis, CardiologistLast updated: 26 July 2026
The pre-school and pre-athletic cardiological check-up covers the Greek school health card (ΑΔΥΜ) and the athlete health card (Κάρτα Υγείας Αθλητή). It certifies that a child or athlete can safely take part in school and sports activities. The full check-up includes a medical history, clinical examination, an electrocardiogram and a cardiac ultrasound (triplex). It is completed in a single visit, with the certificate issued on the spot.
The Pre-Athletic & Pre-School cardiological checkup is of vital importance for the prevention of tragic incidents of sudden death. Young, healthy individuals may suffer from cardiovascular diseases that have not been diagnosed which require treatment and monitoring for participation in sports activities or possibly prohibit participation altogether.
A Pre-Athletic & Pre-School checkup includes the following:
- Medical History: Includes detailed questions about both the patient's individual health history and the family history of cardiovascular diseases.
- Clinical Examination: Involves listening with a stethoscope, checking arteries, pulses, respiratory rate, and any signs of abnormalities in the heart, such as murmurs.
- Electrocardiogram (ECG): The examination with an electrocardiogram helps diagnose arrhythmias, myocardial diseases, congenital cardiovascular diseases, and rare syndromes, all of which may be prohibitive for sports activities.
- Cardiac Triplex: Although the cardiac triplex is a more specialized cardiological examination, it has started to be included in the program of a comprehensive Pre-Athletic & Pre-School Checkup as it provides critical information about the anatomy and function of the heart.
While the Pre-Athletic & Pre-School Checkup is often perceived as a routine examination, it is, in reality, a crucial examination with the potential to save the lives of young people with underlying cardiovascular problems.
Frequently Asked Questions
What does the pre-athletic cardiac check-up include?
It includes a detailed personal and family history, a clinical cardiac examination and a resting electrocardiogram. The full check-up also includes a cardiac ultrasound (triplex): it is not part of the basic protocol, but it gives a considerably more complete picture, revealing structural heart conditions that may not show on an electrocardiogram, such as hypertrophic cardiomyopathy.
Why is pre-participation screening important?
Its goal is to prevent sudden cardiac death in sports. Young, apparently healthy individuals may have undiagnosed heart conditions — such as cardiomyopathies or rhythm disorders — that make intense exercise dangerous. Timely screening allows safe participation or appropriate follow-up.
At what age is the pre-school cardiac check-up done?
The pre-school check-up is usually performed before starting kindergarten or primary school, as part of the Student Health Card requirements in Greece. Pre-athletic screening applies to every age — from children starting a sport to adults who train regularly.
Which sports activities require a cardiac check-up?
The check-up is usually requested when joining an athletics club or a gym, and for taking part in organised sport — football, basketball, volleyball, swimming, athletics, tennis, martial arts and dance. It applies to children and teenagers as well as adults starting regular exercise.
Does a child without symptoms need a cardiac check-up?
Yes, and that is precisely the purpose of preventive screening. Most cardiac conditions that can cause problems during exercise produce no symptoms beforehand. A child who appears completely healthy may have a finding that is only detected through the medical history, clinical examination and electrocardiogram.
Do I need a certificate for school or for the gym?
The same cardiac assessment covers both. It applies to children enrolling in nursery or school, and to children and adults taking part in sport at a gym, an athletics club or a school team. The certificate is issued at the end of the visit.
Is the athlete health card (Κάρτα Υγείας Αθλητή) completed at the clinic?
Yes. The check-up includes the medical history, clinical examination and electrocardiogram required for the athlete health card, and the card is completed and signed by the cardiologist at the end of the visit. If a cardiac ultrasound is needed, it is performed during the same visit.
Is the school health card (ΑΔΥΜ) completed at the clinic?
Yes. The cardiac assessment required for the Greek school health card is carried out at the clinic and the card is completed at the end of the visit, provided no findings require further investigation.
How long does the check-up take and when do I get the certificate?
The basic check-up — history, clinical examination and electrocardiogram — is completed in about 20 to 30 minutes, in a single visit. Provided there are no findings requiring further investigation, the medical certificate is issued immediately, on the same day.
How often should pre-athletic screening be repeated?
As a rule, pre-athletic screening is repeated annually, since school and sports certificates are usually valid for one year. For athletes with findings or a significant family history, the cardiologist may recommend closer or more specialized follow-up.
The information above is educational and does not replace medical advice.
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