Abstract 15217: Prevalence of Abnormal Cardiovascular Findings in Preparticipation Cardiovascular Screening by Focused Echocardiography in Collegiate Athletes
Background: Sudden cardiac arrest in a young healthy athlete is a rare but catastrophic event. Current American Heart Association preparticipation screening (AHA PPS) guidelines recommend a focused history and physical without routine imaging or ECG screening. We propose that a focused echocardiogram is a useful modality to identify structural abnormalities that may lead to sudden cardiac arrest or other cardiovascular events in athletes.
Methods: We performed a focused 5 minute echocardiogram on all incoming varsity Division I collegiate athletes at the University of Wisconsin from 2005 to 2013. The echocardiograms were performed on the same day as their routine AHA-based PPS exam. Abnormal findings on a focused echocardiogram prompted further testing for confirmation. In this investigation, we report the prevalence of abnormal findings in these athletes.
Results: Of the 2898 athletes screened, 1484 (51.2%) were female. The average age was 18.8 years. The majority (98.3%) of athletes had normal screens. Of the abnormalities (N=162, 5.6%) detected, the most common included bicuspid aortic valve (N=21, 0.7%), right ventricular enlargement (N=22, 0.8%), mitral valve prolapse (N=24, 0.8%), atrial septal defect (N=19, 0.7%), and moderate pulmonic regurgitation (N=17, 0.6%). Coronary artery origin abnormalities, comprising abnormal takeoffs (high and/or benign course) and 1 with a common left main and right coronary origin, were identified in 18 (0.6%) athletes. None of these athletes were disqualified from participation. Forty-nine athletes (1.7%) had abnormal screens that resulted in further testing. Four (0.14%) of these athletes had findings that warranted restriction of participation: 1 apical-variant hypertrophic cardiomyopathy, 1 hypertrophic cardiomyopathy, 1 large bidirectional atrial septal defect with right ventricular dysfunction, and 1 dilated ascending aorta. Of these 4 findings, two were new diagnoses and would not have been detected on routine AHA PPS. Only 24 of the 49 abnormal screens had a positive AHA PPS.
Conclusion: Focused screening echocardiography represents an effective non-invasive method to identify cardiac abnormalities that cannot otherwise be identified on routine guideline recommended PPS.
Author Disclosures: S. Hegde: None. D. Modaff: None. D. Helwig: None. N. Bell: None. P. Rahko: None.
- © 2014 by American Heart Association, Inc.