“Do I need an ADYM or an Athlete Health Card?”
“Is an examination by the pediatrician enough, or do we also need to see a cardiologist?”
These are questions parents often ask, especially at the start of the school year or when a child begins an organised sports activity.
The Student Individual Health Record (ADYM) and the
Athlete Health Card (KYA) are not the same document and do not serve the same purpose.
The first mainly concerns the child’s participation in school life and Physical Education. The second is linked to participation in organised sport under the applicable legal framework.
Let’s look at the main differences.
Student Individual Health Record (ADYM)
The ADYM is an official document used at school in Greece and serves as a certificate of the student’s health monitoring.
It is not simply a “note saying the child can exercise”. It is completed after a preventive medical examination, which includes taking a medical history and a physical examination of the child. Further specialised testing is carried out when there is a relevant medical indication.
The ADYM is required for the student to take part in Physical Education and other school sports activities, in accordance with the applicable regulations.
It is submitted at specific stages of schooling, including at enrolment in kindergarten and the 1st grade of primary school, at the start of the 4th grade of primary school, and after enrolment in the 1st year of lower secondary school (Gymnasio) and upper secondary school (Lykeio).
What does the pediatrician check for the ADYM?
The ADYM visit is a good opportunity for a
comprehensive preventive check-up.
The pediatrician reviews the personal and family history and carries out a clinical examination. Depending on the child’s age and history, the assessment may include growth, the cardiovascular and respiratory systems, blood pressure, the musculoskeletal system, vision and hearing, the progress of puberty and other aspects of physical and developmental health.
It is also an opportunity to check vaccination status and to discuss nutrition, sleep, physical activity and, for older children and teenagers, psychosocial health.
The official ADYM form states that additional specialist testing is requested when there are specific medical indications.
Who can complete the ADYM?
The legal framework provides that the ADYM may be completed and signed by a pediatrician or general practitioner and, in special cases, by an internist, with exceptions for areas where access to these specialties is difficult.
For a child or teenager, an examination by the pediatrician has the advantage that it can be part of their overall preventive care rather than being limited to issuing a certificate.
In other words, the ADYM can be the occasion for a real check-up of the child.
And what is the Athlete Health Card?
The Athlete Health Card serves a different purpose. It is linked to
organised sports activity and registered athlete status and is not replaced by the ADYM.
Likewise, the ADYM is not replaced by the Athlete Health Card when the school asks for it.
So a child who goes to school and is also officially registered with a sports club may, depending on the case, need both documents.
Why does pre-participation cardiac screening matter?
Sport has huge benefits for children’s physical and mental health and should be encouraged.
Pre-participation screening is not meant to keep children away from sport. Its aim is to identify those rare cases where there is a health problem that needs further investigation or specific advice before taking part in intense exercise.
The personal and family cardiac history is especially important.
Symptoms such as fainting or near-fainting during exercise, chest pain related to exertion, unexplained breathlessness, a sensation of strong palpitations or markedly reduced exercise tolerance need assessment.
It is equally important for the doctor to know whether there is a family history of sudden or unexplained death at a young age, cardiomyopathy, serious arrhythmias or a known inherited heart condition.
Does every child need an ECG and a heart ultrasound?
Generalisations should be avoided here.
The cardiac assessment of a young athlete is not simply “an echo just to be sure”. Different heart conditions are detected in different ways, and no single test rules out every possible condition.
In fact, in 2026 a specific European consensus on the cardiac evaluation of pediatric athletes was published. It proposes that cardiovascular pre-participation screening should include personal and family history, clinical examination and a resting 12-lead ECG, starting at the latest at age 12.
A heart ultrasound (echocardiogram) can be useful in selected cases, and the same European document states that a transthoracic echocardiogram may be appropriate for detecting certain structural conditions not seen on the ECG. This does not mean, however, that
every healthy child must have an annual heart echo.
When something suspicious emerges from the history, clinical examination or ECG, the assessment is individualised and further tests by a cardiologist may be needed.
So, pediatrician or cardiologist?
The right answer is not “one or the other”, because the two specialties have different and complementary roles.
The pediatrician assesses the child’s overall health, development and history. They can recognise symptoms or risk factors that need further investigation and refer to the appropriate specialist.
The cardiologist carries out the specialised cardiac assessment when it is needed and interprets cardiac findings in the appropriate clinical context.
For children and teenagers who play sport regularly, good cooperation between pediatrician and cardiologist is often far more meaningful than the question of which specialty “takes precedence”.
ADYM and Athlete Health Card at a glance
ADYM: concerns school and participation in school Physical Education. It is based on a preventive medical examination and, when there are indications, leads to further specialist testing.
Athlete Health Card: concerns organised sports activity within the framework set by sports legislation and has a different purpose from the ADYM.
The two documents should not be confused and, when a child falls into both categories, they may need both.
The signature is not the most important thing
Whether it is the ADYM or pre-participation screening, the goal should not simply be to fill in yet another form.
It is an opportunity to pause for a moment on the health of a growing child: to listen to their history, examine their development, look for symptoms that may not have been discussed before and decide whether any more specialised testing is needed.
Sport is valuable for children. Proper preventive screening is not meant to frighten them away from it or limit it, but to help every child take part in sport as safely as possible.
For appointments and information, contact Dr. Giannis Ritsas, pediatrician Thessaloniki and pediatrician Evosmos.