Screening sportsmen for signs of hidden heart conditions could save lives, a study has concluded.
Each year in the UK, hundreds of apparently fit people suffer 'sudden cardiac death'.
In Italy, athletes have to undergo ECG tests, and scientists writing in the British Medical Journal said this had detected heart problems.
UK campaigners have called for the widening of testing of UK sportspeople, and even routine testing of teenagers.
"The test we do costs £35, but when you consider the cost of the pair of trainers that the athlete is wearing, it seems a small price to pay for a test that could save your life"
While cardiac death in the young is unlikely, it can strike without warning, and affect elite athletes as well as ordinary young people.
Probably the best known recent case involved the death of Cameroon footballer Marc Vivien Foe, who collapsed and died while in the middle of a match.
One estimate suggested that every three days, one young competitive athlete in the US dies as the result of an undiagnosed cardiovascular disorder.
There has been debate over the use of ECG tests as a way of looking for these, with controversy over the likely cost, and whether it might jeopardise the career of promising athletes on the basis of a false positive reading.
Currently, in the US and Europe, most sporting authorities screen would-be competitors with a physical examination, and a detailed patient and family history.
The Italian study, carried out at the Institute of Sports Medicine in Florence, suggests that ECG would be a highly effective way to find those most at risk.
The system uses two ECG tests, one at rest and one while exercising.
The resting ECG found that 1.2% of those screened had a previously undetected heart abnormality but this rose to almost 5% in the exercise ECG.
The exercise ECG was more likely to find problems in older athletes.
Undetected problems
A total of 159 people were disqualified from sporting competition on the basis of their results, and only in six cases would the routine examination have picked up the problem.
Alison Cox, the founder and chief executive of the charity Cardiac Risk in the Young, which carries out ECG screening in the UK, said she hoped that the research would encourage an expansion in the demand for the service among community athletics clubs and elite sports people.
She said that current estimates suggested there were at least 400 sudden cardiac deaths in younger people every year.
She said: "We have been calling for this since 1995, when many people were dismissing the idea.
"The test we do costs £35, but when you consider the cost of the pair of trainers that the athlete is wearing, it seems a small price to pay for a test that could save your life."
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