Why doesn't CRY screen people under 14?

Our lower age limit for screening at CRY is 14 years of age. This is because we believe that most people at the age of 14 are well into puberty. This is important for us because conditions such as hypertrophic cardiomyopathy do not manifest fully until the pubertal spurt. Therefore there is a risk that if we screen people well below the age of 14 who have not reached puberty, we will miss people with hypertrophic cardiomyopathy. Conversely, in people under the age of 14, the heart is physically immature. Therefore there are certain abnormalities which include T-wave inversions, V1, V2 and V3 are common in young people. Unfortunately this ECG pattern overlaps with that seen in arrhythmogenic right ventricular cardiomyopathy so there is a risk of generating false positives in that situation. In summary, if we screened people under the age of 14, we may have false negatives in relation to hypertrophic cardiomyopathy and we may have false positives in relation to arrhythmogenic right ventricular cardiomyopathy.