Echocardiographic screening of the athletic adolescent

Sports-related sudden death in adolescent athletes is usually the result of previously undetected heart disease. The most common causes are hypertrophic cardiomyopathy, left coronary artery anomaly, and Marfan's syndrome. Comprehensive cardiovascular history and physical examinations can select a group of adolescents suspected of having heart disease and increased risk of sudden death. Echocardiography plays an important role in the further diagnostic evaluation of these adolescents. Although echocardiography would make an ideal screening test, it is impractical at this time considering the millions of adolescents undergoing preparticipation sports evaluations each year. For now, continued education of the examining physician and appropriate use of diagnostic studies are needed.