Cardiac Preparticipation Sports Screening

Question 1

What is the most common cardiac cause of sudden death among the U.S. athlete?

Answer 1

Hypertrophic cardiomyopathy

Question 2

What are some (4) less common causes of cardiac sudden death in the young athlete?

Answer 2

Coronary artery anomalies, commotio cordis (blow to the chest resulting in V-fib), aortic rupture (Marfan), other (long QT, WPW, AS).

Question 3

What is the screening recommendation before an athlete can participate in high school or college sports?

Answer 3

Targeted history and cardiovascular-focused physical exam to identify high-risk athletes who would require further workup.

Question 4

What are some red-flag symptoms which should prompt further workup in an athlete undergoing a preparticipation sports screening?

Answer 4

Exertional syncope, near syncope, chest pain, excessive fatigue, and shortness of breath.

Question 5

What are some family history findings which would be worrisome for underlying cardiac pathology in an athlete coming in for a sports physical?

Answer 5

Premature death or diability from heart disease in young relatives (<50 years), Marfan’s, hypertrophic cardiomyopathy, and long QT synromes.

Question 6

What are some physical exam findings which should prompt further evaluation in a young athlete presenting for a sports physical?

Answer 6

Stigmata of Marfan’s, elevated BP, absent/diminished femoral pulses, and pathologic murmurs.