Retrospective Evaluation of Children Applying for Athlete Licenses

Objective: The numbers of children and adolescents taking part in sporting activities has risen increasingly in recent years, but sudden deaths occurring during matches or training are a cause for concern among families and in society. The purpose of the study was to seek an answer to the question of whether children should be evaluated by a pediatric cardiologist for sports licenses. Material and Methods: 168 children aged 7-17 who had newly started sporting activities or doing sport for some time were included in the study. Participants underwent a detailed physical examination and were assessed by a pediatric cardiologist. Athletes were examined using history, physical examination, 12-channel echocardiogram and echocardiography. Children with arrhythmia were investigated using 24-h Holter monitoring. Results: 168 cases, 136 (81%) boys and 32 (19%) girls were enrolled. The mean age of the cases was 13 years. Pathology was determined in 4.1% of all subjects at electrocardiogram and in 11.9% at echocardiography. Effort tests were applied to 14 children with significant symptoms, in whom arrhythmia was determined or with a family history, 24-h rhythm Holter monitoring to five children and ambulatory Holter monitoring to one hypertensive child. Holter monitoring revealed frequent isolated monomorphic ventricular premature contraction in two subjects. Seven participants were eventually suspended from sporting activities. Conclusion:National guidelines including presport cardiovascular evaluation have been developed in order to prevent sports-related sudden deaths. The main conclusion from our findings is that young children engaging in sports should be evaluated by a pediatric cardiologist before starting sporting activities.