Screening for risk factors of sudden cardiac death in young athletes

Sudden cardiac death in young athletes is relatively uncommon and is usually caused by occult underlying cardiovascular disease. Studies have indicated that preparticipation screening may reduce the incidence of sudden death. Our aim was to study the feasibility of standardized preparticipation screening in young competitive Icelandic athletes. The prevalence of risk factors was studied in order to evaluate how often further examination is indicated and to assess possible costs. A total of 105 randomly selected competitive athletes (70 men, 35 women) between the age 18-35 received standard screening with medical history, cardiac examination and 12 lead ECG. The most frequent complaints revealed by medical history were allergy, excema, asthma, dyspnea on exercise, chest pain on exercise, palpitations on exercise, dizziness and fainting on exercise. Physical examination was abnormal in 20 (19%). 12 lead ECG was distinctly abnormal in 22 (21%) and mildly abnormal in 23 (22%). Transthoracal echocardiography (TTE) was performed on 19 (18%). Of those, TTE was normal in six athletes (32%) and mildly abnormal in 13 (68%), none had abnormal findings indicating structural heart disease. Symptoms associated with cardiac disease are frequently described among young athletes. Abnormal ECG was commonly found. Further examination with echocardiography may be indicated in one of every four athletes screened.