Back to School: What Parents Need to Know About Florida’s New EKG Requirement for Student Athletes

If your teenager plays high school sports in Florida, you have one more item to check off your back-to-school list before the new season begins.

Beginning this 2026-27 school year, students participating in Florida High School Athletic Association sports for the first time must complete a one-time electrocardiogram (ECG, commonly called EKG) before competing under the state’s new Second Chance Act.

The goal is to identify hidden heart conditions that could increase the risk of sports-related sudden cardiac arrest (SrSCA). The new requirement may offer an added layer of protection against rare heart conditions in teenagers, but ECGs don’t catch every potential heart problem and can be easily misinterpreted in athletes, says Thomas Best, M.D., Ph.D., a sports medicine physician at UHealth.

“ECGs can be helpful, but they don’t pick up as many problems as we think. It’s important for families to understand both the benefits and the limitations.”

Why Florida is the first state to require EKGs for sports

The new EKG law was mandated to help identify student-athletes who may have underlying heart conditions before they step onto the field or court. Although sudden cardiac death in young athletes is rare, it’s obviously devastating.

“When these events occur, they are incredibly emotional. Everyone wants to do everything possible to prevent them,” says Dr. Best.

An ECG is a quick, painless test that measures the heart’s electrical activity. It can help identify certain rhythm disorders and other electrical abnormalities that might otherwise go unnoticed.

For many families, EKG screening will simply become another part of the back-to-school sports physical process.

What to expect at an EKG screening

An EKG is a noninvasive screening test that can be performed at many general practitioners’ offices:

1. The clinician places several small adhesive electrodes on your child’s chest, arms and legs.
2. The electrodes are connected to a machine that records the heart’s electrical activity.
3. The test itself takes just a few minutes, so the entire appointment is typically less than 15 minutes.

Your child won’t feel electricity or receive any shocks. Results are often available the same day.

What an EKG can and can’t detect

Like every screening test, an ECG has strengths and limitations. The test is particularly useful for detecting some electrical disorders of the heart. However, it’s not a very effective screening tool for structural heart problems, such as certain valve abnormalities or other issues affecting the heart’s anatomy. “It will raise the bar a bit, but probably only for a select number of conditions, which is why the American Heart Association and American College of Cardiology recommend starting with a health history and physical exam before including an EKG,” says Dr. Best.

An abnormal EKG doesn’t mean the season is over

One of the biggest misconceptions about heart screening for high school sports is that an abnormal result automatically ends an athlete’s participation. In most cases, findings simply require additional evaluation by a cardiologist.

“Many of these ECGs are false positives. This is going to put a certain number of families through a period of uncertainty until they get an answer,” says Dr. Best.

Part of the challenge is that reading an athlete’s ECG isn’t always straightforward.

Regular athletic training can cause normal changes in the heart that look different from those of non-athletes. Plus, it’s common for healthy Black individuals to display normal EKG variants that may resemble life-threatening conditions or structural diseases in other ethnicities. Interpreting those findings correctly and preventing false positives requires training and experience.

“A lot of people are not well qualified to interpret EKGs in athletes,” says Dr. Best.

If an ECG raises concerns, Dr. Best recommends seeking further evaluation from a physician experienced in sports cardiology or pediatric cardiology. That said, parents should stay calm and be prepared for additional testing after an abnormal result.

One safety measure remains essential

While the new screening requirement is designed to improve early detection of certain heart conditions, Dr. Best says the most significant lifesaving tool for the rare occurrence of a cardiac event during sports is an automated external defibrillator (AED).

“The best defense right now for preventing certain cardiac deaths is having AEDs and people who know how to use them on the sidelines,” he says.

When sudden cardiac arrest occurs during sports, immediate CPR and rapid access to an AED can dramatically improve the chances of survival. “The athletes who have collapsed on the field and have survived were for the most part resuscitated by AED,” says Dr. Best.

As schools prepare for a new sports season, Dr. Best recommends not only completing required screenings but also ensuring athletic facilities have AEDs readily available and staff trained to respond in an emergency.

What parents of athletes should do now

If your child plans to play high school sports in Florida:

1. Schedule the required EKG well before the season begins. Some schools and community organizations are organizing EKG screening events, so check with your child’s athletic department.

2. Complete the pre-participation sports physical and share any family history of heart disease or sudden cardiac death with your child’s provider.

3. If an EKG is abnormal, don’t panic. Most athletes will simply need additional evaluation to determine whether the finding is significant.

4. Ask about emergency preparedness, including access to AEDs and trained personnel where your child practices and competes.

If your child needs a pre-participation sports evaluation or follow-up after an abnormal EKG, the sports medicine and pediatric cardiology experts at UHealth can help determine the next steps and provide individualized recommendations for safe participation in sports.

Written by Wendy Margolin. Reviewed by Dr. Thomas Best, a sports medicine physician at UHealth.

Tags: Dr. Thomas Best, Florida high school student athlete, Sports Medicine Institute, student athlete ECG, student athlete EKG