The latest edition of Medicine & Science in Sports & Exercise (Oct 1998)
featured a few interesting articles on preparticipation screening for cardiac
disease in sport. The abstracts follow. This information may be of interest
to anyone who has concerns about this issue.
Dr Mel C Siff
Littleton, Colorado, USA
[log in to unmask]
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Preparticipation physical evaluation: getting to the heart of the matter
JOHN D. CANTWELL
Morehouse School of Medicine, the Atlanta Braves, and Georgia Tech Athletic
Department, Atlanta, GA
CANTWELL, J. D. Preparticipation physical evaluation: getting to the heart of
the matter. Med. Sci. Sports Exerc., Vol. 30, No. 10(Suppl.), pp. S341-S344,
1998.
The cardiovascular evaluation is an important component of the
preparticipation physical examination of the athlete. The history should be
standardized to include questions ranging from those about chest pain and
palpitations to ones about syncope. The physical examination should not be a
perfunctory one, but rather a careful search for findings that might include a
low grade heart murmur that accentuates with Valsalva'a maneuver (suggestive
of hypertrophic cardiomyopathy, the leading cause of sudden death in a
competitive athlete). The cardiovascular
risks to the athlete are known. Fortunately, only a small percentage of
athletes who are screened have such abnormalities. The validity of such
screening remains to be proven. Recommendations are provided to make the
present approach more time efficient and perhaps more cost effective.
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Does preseason screening for cardiac disease really work?:
The British perspective
DOMHNALL MACAULEY
Division of Epidemiology, The Queen's University of Belfast, Royal Victoria
Hospital, Belfast, NORTHERN IRELAND
MACAULEY, D. Does preseason screening for cardiac disease really work?: the
British perspective. Med. Sci. Sports Exerc., Vol. 30, No.10(Suppl.), pp.
S345-S350, 1998.
Sudden cardiac death is always a tragedy. Sudden death during sport is
particularly poignant because people tend to associate sport with health and
fitness. Both the public and the medical profession would like to prevent such
events, and preparticipation medical screening is often promoted as one such
method. When we examine the risk of death, the prevalence of at-risk
conditions, the natural
history of disease, and the screening methods available, it is clear that
widespread screening would not be useful. Systematic preparticipation
screening is not undertaken widely in the United Kingdom, but this practice
has evolved and is not the result of a definite policy decision.
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Insights into the AHA scientific statement concerning cardiovascular
preparticipation screening of competitive athletes
CHRISTOPHER A. MCGREW
Department of Orthopaedics, Sports Medicine Division, and Department of Family
Practice, University of New Mexico Health Sciences Center, Albuquerque, NM
87131-5296
MCGREW, C. A. Insights into the AHA scientific statement concerning
cardiovascular preparticipation screening of competitive athletes. Med. Sci.
Sports Exerc., Vol. 30, No. 10(Suppl.), pp. S351-S353, 1998.
In 1996 the American Heart Association (AHA) published recommendations
concerning the cardiovascular component of the preparticipation exam in
competitive athletes as part of an AHA medical scientific statement. This
article will review the rationale for the development of such a statement and
how it has been incorporated into the current state-of-the-art
preparticipation exam of athletes.
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