Echocardiographic Screening as Part of a Preparticipation Examination

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Abstract
Hypertrophic cardiomyopathy, though extremely rare is the most common identifiable cardiac abnormality associated with an “indirect cause” of sudden death in young athletes. The purpose of the screening reported here was to assess the practicality of incorporating a limited echocardiographic evaluation into a station-oriented preseason preparticipation physical examination program for junior and senior high school athletes; 1,570 scholastic athletes were studied over a 3-year period. Each athlete had a limited echocardiographic evaluation that included a parasternal longitudinal axis view with particular attention to the left ventricular outflow tract, left ventricular posterior wall, and septal thickness. No athlete had any subaortic narrowing, left ventricular wall thickness > 12 mm, or ventricular septal thickness > 12 mm. None of the athletes reported any conditions compatible with hypertrophic cardiomyopathy during history or personal questioning. The projected cost of these evaluations on 600 athletes would have been $300,000. In conclusion, it does not appear to be appropriate to require an echocardiographic evaluation to exclude hypertrophic cardiomyopathy in scholastic athletic preparticipation examinations.

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