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=== International level === An [[observational study]] held from professional footballers -active (during their career) and recently retired (post-career, aged more than 45 years)- in 70 countries between 2007 and 2013, elaborated on data from the World Footballers' Union (FIFPro), recorded 214 deaths of which 25% was caused by accidents, 11% by suicides and 33% by a suspected [[cardiac disease|cardiac]] [[pathology]] (on an overall 55% of deaths caused by some sort of disease).<ref>{{cite journal | author = V Gouttebarge | author2 = W Ooms | author3 = T Tummers | author4 = H Inklaar | url = https://www.minervamedica.it/en/journals/sports-med-physical-fitness/article.php?cod=R40Y2015N11A1376 | title = Mortality in international professional football (soccer): a descriptive study | journal = The Journal of Sports Medicine and Physical Fitness | date = November 1, 2015 | volume = 55 | issue = 11 | pages = 1376β82 | pmid = 25289716 | format = PDF | access-date = September 12, 2020 | oclc = 8086984568 | issn = 0022-4707}}</ref> Clinical evaluation, [[ECG]], and [[echocardiography]] are required for the athletes as pre-participation tools in order to prevent [[Sudden cardiac death of athletes|sudden cardiac deaths]] in people aged less than 35. To evaluate the risk of [[myocardial fibrosis]], may use and recommend the additional use of [[Cardiac magnetic resonance imaging#Late gadolinium enhancement|late gadolinium enhancement]] (LGE) with pre- and post-contrast and [[Sodium MRI|extracellular volume fraction]] (ECV) images.<ref>{{cite journal | title = Sudden cardiac death in football players: Towards a new pre-participation algorithm | author = Sophie I. Mavrogeni | author2 = Konstantinos Tsarouhas | author3 = Demetrios A. Spandidos | author4 = Christina Kanaka-Gantenbein | author5 = Flora Bacopoulou | pmid = 30679986 | doi = 10.3892/etm.2018.7041 | journal = Experimental and Therapeutic Medicine | date = February 1, 2019 | volume = 17 | issue = 2 | pages = 1792β0981| issn = 1792-1015 | publisher = [[Spandidos Publications]] | pmc = 6327574 | oclc = 7991416583}}</ref> Even encouraged, it wasn't yet made mandatory.
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