Screening Procedures For Sudden Cardiac Death in Youth Athletes
Aug 24, 2023
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This podcast discusses pre participation screening for sudden cardiac death in youth athletes. It explores the importance of screening, the effectiveness and long-term outcomes of screening procedures, and the significance of early detection and intervention for potential cardiac risk factors in young athletes.
Pre-participation screening, including history assessment and clinical examination, plays a crucial role in identifying potential cardiac conditions in youth athletes.
Abnormal resting ECG and exercise stress tests, rather than family history or physical exams, are more effective in diagnosing cardiovascular diseases in youth athletes.
Deep dives
Pre-Participation Screening for Youth Athletes
This podcast episode discusses the importance of pre-participation screening for young competitive athletes. The episode focuses on a study conducted in Italy, where a pre-participation screening examination was created for youth athletes aged 7 to 18. The screening included a history assessment, clinical examination, resting 12-lead ECG, and cardiac stress testing. Out of the 22,000 athletes involved in the study, 1.8% were diagnosed with cardiovascular diseases, with a greater diagnostic yield in the older age group. Interestingly, only 30% of those with a positive diagnosis had a positive family history or abnormal physical exam. The study demonstrated the value of screening in identifying potential cardiac conditions in youth athletes and promoting their safety in sports participation.
Diagnostic Yield and Long-Term Outcomes
The study found that 1.5% of the diagnosed cardiovascular diseases were not associated with sudden cardiac death, while 0.3% were linked to sudden cardiac death. Most positive diagnoses came from abnormal resting ECG or exercise stress tests, rather than family history or physical exams. Follow-up examinations detected a significant number of cases that were missed initially. The study also evaluated the cost per diagnosis, which ranged from $140,000 to $66,000 depending on the age group. Interestingly, only one individual out of the 22,000 experienced sudden cardiac death, and this individual tested negative on multiple cardiovascular evaluations prior. These findings highlight the importance of repeat screening exams and suggest that the screening process can successfully identify individuals at risk of sudden cardiac events.
Limitations and Practice Implications
The study's limitations included the resource-intensive nature of the screening process, which may not be feasible in all settings, especially those with limited resources. Additionally, the study's narrow geographic focus raises questions about generalizability to other populations. Despite these limitations, the study emphasizes that about 2% of asymptomatic athletes were diagnosed with cardiovascular diseases, prompting the need for further screening. History and physical exams alone were insufficient in identifying these conditions. The findings advocate for incorporating comprehensive screenings, particularly resting 12-lead ECG and exercise stress tests, to effectively detect underlying cardiac diseases and prevent potential risks in athletes participating in sports.
Pre participation screening plays a large role in risk mitigation with athletes. This episiode discusses litrerature in regards to pre participaton screeningprocedures for sudden cardiac death in youth athletes.
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