Even a pretty thorough pre-participation physical probably won't include an echocardiogram (which is the study used to detect aneurysms.) A pre-participation physical in an otherwise healthy person less than 40 (such as high school sports physicals) typically don't include much more than a thorough history, vitals signs and a physical exam. After 40 you'd consider an EKG or treadmill stress test.
As pre-participation physicals go I'd say 99% of problems are picked up by history. Any major tests are usually ordered only for those with a significant complaint (such as chest pain, shortness of breath etc. with exercise ) or some major history (family member with sudden cardiac death at age 35.) I've done high school/college sport physicals for 12 years and can remember 2 times I've ordered further testing for something I found during the physical exam. That's why you hear so many stories of athletes who have had normal physicals having some major event. Unless they were "lucky" enough to have symptoms before the major event or have some other family history etc. the problem probably won't be picked up.
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