Early Screening for Cardiovascular Abnormalities With Preparticipation Echocardiography: Feasibility Study

Area of Science:

• Cardiology
• Sports Medicine
• Medical Imaging

Background:

• Traditional history and physical (H&P) exams are insufficient for identifying athletes at risk of sudden cardiac death.
• Electrocardiograms (ECG) show high false-positive rates, leading to unnecessary further testing.
• Limited portable echocardiograms by frontline physicians (PEFP) offer direct cardiac measurements for improved accuracy.

Purpose of the Study:

• To assess the feasibility of integrating limited PEFP into routine preparticipation physical examinations (PPE).
• To compare the accuracy and efficiency of PEFP against traditional H&P and ECG screening methods.

Main Methods:

• Prospective enrollment of 35 Division I male collegiate athletes who provided informed consent.
• Screening included H&P (2007 AHA guidelines), ECG (2013 Seattle Criteria), and limited PEFP (parasternal long axis view measurements).
• Screening station times were recorded and compared using ANOVA; statistical significance set at P < 0.05.

Main Results:

• Limited PEFP screening was significantly faster (137.7 ± 40.4 sec) than H&P (244.2 ± 80.0 sec) and ECG (244.9 ± 85.6 sec) (P < 0.01).
• H&P identified 6 positive findings, ECG identified 3 positive findings; PEFP identified 2 borderline findings.
• All athletes with positive ECG or borderline PEFP findings were referred for cardiology evaluation; none were disqualified, but one required annual monitoring.

Conclusions:

• Incorporating limited PEFP into PPEs can reduce false-positive and false-negative cardiac screens.
• Limited PEFP is the most time-efficient screening modality compared to H&P and ECG.
• Limited PEFP offers the highest value in PPE by providing accurate information with minimal time expenditure.