Key result
Adding point-of-care cardiac ultrasound to preparticipation athletic screening detects cardiac abnormalities with demonstrated feasibility.
Why the study?
There is limited data about implementing point of care cardiac ultrasound in preparticipation screening for young athletes to prevent sudden cardiac death.
Does adding point-of-care cardiac ultrasound to standard H&P and ECG improve the detection of cardiac abnormalities in collegiate athletes?
Cross-Sectional (n=42)
No
Does adding point-of-care cardiac ultrasound to standard H&P and ECG improve the detection of cardiac abnormalities in collegiate athletes?
Adding point-of-care cardiac ultrasound to standard preparticipation screening for collegiate athletes is feasible and may identify abnormalities missed by history, physical, and ECG alone.
Answers are grounded in this paper and cite their sources.
Does not support routine adoption in athlete screening; leaves open value in larger prospective studies.
INTRODUCTION: Sudden cardiac death is a rare cause of death in young athletes. Current screening techniques include history and physical exam (H and P), with or without an electrocardiogram (ECG). Adding point of care cardiac ultrasound has demonstrated benefits, but there is limited data about implementing this technology. We evaluated the feasibility of adding ultrasound to preparticipation screening for collegiate athletes. METHODS: We prospectively enrolled 42 collegiate athletes randomly selected from several sports. All athletes were screened using a 14-point H and P based on 2014 American College of Cardiology (ACC) and American Heart Association (AHA) guidelines, ECG, and cardiac ultrasound. RESULTS: We screened 11 female and 31 male athletes. On ultrasound, male athletes demonstrated significantly larger interventricular septal wall thickness (p = 0.002), posterior wall thickness (p <0.001) and aortic root breadth (p = 0.002) compared to females. Based on H and P and ECGs alone and a combination of H and P with ECG, no athletes demonstrated a positive screening for cardiac abnormalities. However, with combined H and P, ECG, and cardiac ultrasound, one athlete demonstrated positive findings. CONCLUSIONS: We believe that adding point of care ultrasound to the preparticipation exam of college athletes is feasible. This workflow may provide a model for athletic departments' screening.
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Fischetti et al. (2019) conducted a cross-sectional in Risk of sudden cardiac death (n=42). Point-of-care cardiac ultrasound vs. History, physical exam, and ECG alone was evaluated on Positive screening for cardiac abnormalities. Adding point-of-care cardiac ultrasound to standard history, physical exam, and ECG screening identified one athlete with concerning cardiac findings out of 42 screened, demonstrating feasibility.
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