Abstract 875: Cardiovascular Screening of Sinister Cardiac Disorders in Young Apparently Healthy Individuals: The Northern Ireland Experience
Objectives: The Italian pre-participation cardiovascular screening (PPS) programme has been shown to reduce the incidence of sudden cardiac death (SCD) from hereditary cardiomyopathy and primary electrical disorders in young competitive athletes. There is a paucity of data regarding the potential outcome of screening all young apparently healthy individuals outside the context of organised competitive sport. The aim of this study was to analyse the outcomes of PPS in order to assess the impact on health care services of general population screening.
Method: 2013 subjects (mean age 18.3 years; range 14 –37 years; male:female ratio 5:1) were screened with a health questionnaire (HQ) and 12-lead electrocardiography (ECG). The questionnaire related to symptoms suggestive of cardiovascular disease and a family history of premature cardiovascular disease and/or SCD. ECGs were analysed for specific abnormalities as described in the ESC sports cardiology consensus. Individuals suspected to harbour a structural cardiac abnormality based on the findings of the HQ and 12-lead ECG underwent trans-thoracic echocardiography (TTE). Individuals suspected to have a primary electrical disorder were referred for additional Holter monitoring and an exercise stress test.
Results: Of the 2013 individuals, 758 (37.7%) expressed one or more symptoms that could be consistent with cardiac disease, 139 (6.9%) had a family history of hereditary cardiomyopathy or SCD and 209 (10.4%) had a 12-lead ECG abnormality warranting further investigation. Following preliminary investigation echocardiography, Holter monitoring and exercise stress testing was necessary in 290 (14.4%), 92 (4.6%) and 89 (4.4%) respectively. A cardiac diagnosis was made in 1.2% of individuals (Wolff-Parkinson-White: n=4, atrial septal defect: n=3, long QT: n=7; minor valvular heart disease: n=9 and atrial fibrillation; n=1).
Conclusions: The beneficial effects of the Italian PPS programme in protecting an athlete from SCD should not be undervalued. Extrapolation of this programme to a general young population is associated with a significant number of individuals (5.1%) requiring additional investigations that are associated with a relatively low yield for conditions capable of causing SCD.