Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-21T23:15:02.704Z Has data issue: false hasContentIssue false

The pre-participation screening in young athletes: which protocol do we need exactly?

Published online by Cambridge University Press:  29 November 2017

İbrahim İ. Çetin*
Affiliation:
Pediatric Cardiology Clinic, Ankara Children’s Hematology Oncology Education and Research Hospital, Ankara, Turkey
Filiz Ekici
Affiliation:
Pediatric Cardiology Clinic, Ankara Children’s Hematology Oncology Education and Research Hospital, Ankara, Turkey
Ayşe E. Kibar
Affiliation:
Pediatric Cardiology Clinic, Ankara Children’s Hematology Oncology Education and Research Hospital, Ankara, Turkey
Murat Sürücü
Affiliation:
Pediatric Cardiology Clinic, Ankara Children’s Hematology Oncology Education and Research Hospital, Ankara, Turkey
Ali Orgun
Affiliation:
Pediatric Cardiology Clinic, Ankara Children’s Hematology Oncology Education and Research Hospital, Ankara, Turkey
*
Correspondence to: İ. İ. Çetin, The Head of Pediatric Cardiology Clinic, Ankara Children’s Hematology Oncology Education and Research Hospital, Ziraat Mah, Kurtdereli Sok, No: 10, Dışkapı, Altındağ 06110, Ankara. Tel: +90 312 5969644; Fax: +90 312 3472330; E-mail: iicetin@hotmail.com

Abstract

The aim was to assess the utility and feasibility of a comprehensive cardiac screening protocol in young athletes before participation in sports. A total of 380 athletes referring before participation in sports, between April, 2014 and April, 2015, were included in this study. The mean age was 12.4 years. A screening protocol has been applied to all, including personal and family history, physical examination, 12-lead electrocardiography, transthoracic echocardiography, 24-hour rhythm Holter analysis, and treadmill exercise test. The most frequent complaints were chest pain in 19 (5%), dyspnoea in 13 (3.4%), and dizziness and fainting in five patients (1.3%) on exercise. There was sudden death and arrhythmia in 41 patients (10.7%) owing to family history. Heart murmur was present in 20 (5.2%) and hypertension in 10 patients (2.6%) on physical examination. The 12-lead electrocardiography was abnormal in 9 patients (2.4%). The findings of transthoracic echocardiography were insignificant in 47 patients (12.3%) and in five patients (1.3%) a haemodynamically important condition was detected. The 24-hour rhythm Holter analysis was abnormal in six patients (1.5%). There were significant ST changes in two patients (0.5%) on treadmill exercise test with normal findings on myocardial perfusion scans. No significant relation was present between findings of screening protocol and transthoracic echocardiography, 24-hour rhythm Holter analysis, or treadmill exercise test results.

Pre-participation screening in young athletes should consist of a targeted personal history, family history, physical examination, and 12-lead electrocardiography. Other tests should be applied only if the screening indicates the presence of a cardiovascular disease.

Type
Original Articles
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Link, MS, Estes, NA. Sudden cardiac death (SCD) in a young athlete commonly brings to the gaps between evidence, policy and practice. Circulation 2012; 125: 25112516.CrossRefGoogle Scholar
2. Koester, MC. A review of sudden cardiac death in young athletes and strategies for preparticipation cardiovascular screening. J Athl Train 2001; 36: 197204.Google Scholar
3. Maron, BJ. How should we screen competitive athletes for cardiovascular disease? Eur Heart J 2005; 26: 428430.Google Scholar
4. American Heart Association 2012, Preparticipation Cardiovascular Screening of Young Competitive Athletes: Policy Guidance. A Statement for Health Professionals From the Sudden Death Committee (Clinical Cardiology) and Congenital Cardiac Defects Committee (Cardiovascular Disease in theYoung), American Heart Association. Retrieved 10 February 2017 from www.heart.org Google Scholar
5. Corrado, D, Pelliccia, A, Heidbuchl, H, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J 2010; 31: 243259.Google Scholar
6. Drezner, JA, Sharma, S, Baggish, A, et al. International criteria for electrocardiographic interpretation in athletes: consensus statement. Br J Sports Med 2017; 51: 704731.Google Scholar
7. Fritsch, P, Dalla Pozza, R, Ehringer-Schetitska, D, et al. Cardiovascular pre-participation screening in young athletes: recommendations of the Association of European Paediatric Cardiology. Cardiol Young 2017; 27: 16551660.Google Scholar
8. Maron, BJ, Zipes, DP. Eligibility recommendations for competitive athletes with cardiovascular abnormalities. J Am Coll Cardiol 2005; 45: 13181321.Google Scholar
9. Maron, BJ, Thompson, PD, Ackerman, MJ, et al. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update. Circulation 2007; 115: 16431655.Google Scholar
10. Corrado, D, Basso, C, Pavei, A, et al. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 2006; 296: 15931601.Google Scholar
11. Corrado, D, Basso, C, Scihiavon, P, Thiene, G. Screening for hypertrophic cardiomyopathy in young athletes. N Engl J Med 1998; 339: 364369.Google Scholar
12. Pelliccia, A, Maron, BJ. Preparticipation cardiovascular evaluation of the competitive athlete: perspectives from the 30-year Italian experience. Am J Cardiol 1995; 75: 827829.Google Scholar
13. Magalski, A, McCoy, M, Zabel, M, et al. Cardiovascular screening with electrocardiography and echocardiography in collegiate athletes. Eur Soc Cardiol 2011; 124: 511518.Google Scholar
14. Baggish, AL, Hutter, AM Jr, Wang, F, et al. Cardiovascular screening in college athletes with and without electrocardiography: a cross-sectional study. Ann Intern Med 2010; 152: 269275.CrossRefGoogle ScholarPubMed
15. Marek, J, Bufalino, V, Davis, J, et al. Feasibility and findings of large-scale electrocardiographic screening in young adults: data from 32,561 subjects. Heart Rhythm 2011; 8: 15551559.Google Scholar
16. Anderson, JB, Grenier, M, Edwards, NM, et al. Usefulness of combined history, physical examination, electrocardiogram, and limited echocardiogram in screening adolescent athletes for risk of sudden cardiac death. Am J Cardiol 2014; 114: 17631767.Google Scholar
17. Glover, DW, Glover, DW, Maron, BJ. Evolution in the process of screening United States High School Student-athletes for cardiovascular disease. Am J Cardiol 2007; 100: 17091712.Google Scholar
18. Maron, BJ, Doerer, JJ, Haas, TS, et al. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980−2006. Circulation 2009; 119: 10851092.Google Scholar
19. Palacio, LE, Link, MS. Commotio Cordis. Sports Health 2009; 1: 174179.Google Scholar
20. Link, MS, Maron, BJ, Stickney, RE, et al. Automated external defibrillator arrhythmia detection in a model of cardiac arrest due to commotio cordis. J Cardiovasc Electrophysiol 2003; 14: 8387.Google Scholar
21. Conley, KM, Bolin, DJ, Carek, PJ, et al. National Athletic Athletes’ Association position statement: preparticipation physical examinations and disqualifying conditions. J Athl Train 2014; 49: 102120.Google Scholar
22. Papadakis, M, Wilson, MG, Ghani, S, et al. Impact of ethnicity upon cardiovascular adaptation in competitive athletes: relevance to preparticipation screening. Br J Sports Med 2012; 46 (S1): i22i28.Google Scholar
23. Maron, BJ, Douglas, PS, Graham, TP, et al. Preparticipation screening and diagnosis of cardiovascular disease in athletes. J Am Coll Cardiol 2005; 45: 13221326.Google Scholar