RT Book, Section
A1 Kiefer, Todd
A1 Granger, Christopher B.
A1 Jackson, Kevin P.
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1193148493
T1 Cardiovascular Screening of Athletes
T2 Current Medical Diagnosis & Treatment 2023
YR 2023
FD 2023
PB McGraw-Hill Education
PP New York, NY
SN 9781264687343
LK accessmedicine.mhmedical.com/content.aspx?aid=1193148493
RD 2024/04/25
AB The  sudden  death  of  a  competitive  athlete  inevitably  becomes  an  occasion  for  local,  if  not  national,  publicity.  On  each  occasion,  the  public  and  the  medical  community  ask  whether  such  events  could  be  prevented  by  more  careful  or  complete  screening.  Although  each  event  is  tragic,  it  must  be  appreciated  that  there  are  approximately  5  million  competitive  athletes  at  the  high  school  level  or  above  in  any  given  year  in  the  United  States.  The  number  of  cardiac  deaths  occurring  during  athletic  participation  is  unknown  but  estimates  at  the  high  school  level  range  from  one  in  100,000  to  one  in  300,000  participants.  Death  rates  among  more  mature  athletes  increase  as  the  prevalence  of  CAD  rises.  These  numbers  highlight  the  problem  of  how  best  to  screen  individual  participants.  Even  an  inexpensive  test  such  as  an  ECG  would  generate  an  enormous  cost  if  required  of  all  athletes,  and  it  is  likely  that  only  a  few  at-risk  individuals  would  be  detected.  Echocardiography,  either  as  a  routine  test  or  as  a  follow-up  examination  for  abnormal  ECGs,  would  be  prohibitively  expensive  except  for  the  elite  professional  athlete.  Thus,  the  most  feasible  approach  is  that  of  a  careful  medical  history  and  cardiac  examination  performed  by  personnel  aware  of  the  conditions  responsible  for  most  sudden  deaths  in  competitive  athletes.