General Cardiology - Preparticipation Screening for Sports

Link to 2007 recommendations from American College of Cardiology.
Barry J Maron, et al. Circulation 2007;115:1643-55

Presence of 1 or more of the 12 elements below should trigger referral for CV evaluation:
Parental verification is regarded essential for high school and middle school students.

12-element AHA recommendations for preparticipation CV screening of compettitive athletes:
Medical History:
Personal History -
1. Exertional chest pain/discomfort
2. Unexplained syncope/near-syncope (judged non-vasovagal; particular concern when related to exertion)
3. Excessive exertional and unexplained dyspnea/fatigue, associated with exercise
4. Prior recognitiion of a heart murmur
5. Elevated BP
Family History -
6. Premature death (sudden and unexpected or otherwise) before age 50 years due to heart disease, in more than or equal to 1 relative.
7. Disability from heart disease in a close relative < 50 years
8. Specific knowledge of certain cardiac conditions in family members: HCM or DCM, LQTS or other ion channelopathies, Marfan syndrome or clinically important arrhythmias

Physical Examination:
9. Heart murmur (auscultation in supine & standing (Or val Salva) specifically for LVOTO murmur.
10. Femoral pulse
11. Features of Marfan syndrome
12. Brachial artery BP (sitting position) (preferably both arms).

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