[Overuse of cardiology tests in healthy children at an Argentinian university hospital].

INTRODUCTION: The requirement for medical clearance prior to starting physical activity in children and adolescents is a common practice, although there is controversy regarding which elements should be included. The Sociedad Argentina de Pediatría recommends filling out a complete medical history, physical examination, and doing one electrocardiogram in the post-pubertal stage. However, in daily consultation, additional studies are often requested which, when inappropriate, may become barriers to physical activity. This study aims to document practices requested as part of physical fitness clearance in our institution and determine what proportion would be potentially inappropriate.

MATERIALS AND METHODS: Cross-sectional study. We included children and adolescents enrolled in our hospital's health insurance plan during 2019 or 2022, with no prior diagnosis of heart disease, who had undergone at least one cardiological evaluation (a test or a cardiology consultation) requested for a physical clearance exam. A random sample was selected and medical records were reviewed using a structured guide to evaluate the types of requested or performed studies and their clinical justification.

RESULTS: The study included 134 participants, of whom 122 (91%, 95% CI 86-96%) had at least one potentially inappropriate investigation. This proportion was higher in children under 13 years of age (98% vs. 85%, p < 0.01). The most frequently requested investigation was the electrocardiogram, followed by cardiology consultation.

CONCLUSION: Inappropriate cardiology practices are common at our institution. These findings are useful for situational analysis and for planning quality improvement interventions.