Abstract 12669: Yield of Systematic Screening for Cardiovascular Disease in Young Sports Participants

Abstract

Background: Although rare, sudden cardiac death (SCD) is a tragic event for young athletes. Comprehensive initial pre-participation physical evaluation (CIPPE) is mandated for middle, junior high and senior high school students by Pennsylvania Interscholastic Athletic Association (PIAA) primarily for reducing potential sports injuries and SCD. Those with positive screening for cardiac disease [on 14-element AHA screening questionnaire] are referred for cardiac evaluation. We prospectively evaluated yield of cardiac screening in this age group. Method: From 2015 to 2023, 424 students [age 10-21 (15±2) years, 60% male, 64% Caucasian, 43% overweight) referred for cardiac screening. Evaluation included 12-lead ECG and rhythm strip (100%), transthoracic echo (96.4%), ambulatory monitor (3.8%), exercise ECG (14.5%), stress echo (2.1%), and cardiac MRI (0.9%). Results: Actionable abnormalities were found in 25 (5.9%) and included hypertension (n=8), bicuspid aortic valve (n=4, Figure:A), ascending aortic aneurysm (n=3, Figure:B*), definite or probable hypertrophic cardiomyopathy (n=3, Figure:C), atrial septal defect (n=2), mitral valve prolapse (n=2), aortic insufficiency (n=1), coronary artery anomaly (n=1) and ventricular tachycardia requiring ablation (n=1). Conclusion: Although uncommon, a systematic approach to screening in young sport participants can lead to identification of serious unsuspected cardiovascular disorders in 1 out of 17 students.