Abstract 15334: Increased Physical Activity is Associated With Lower Prevalence of Cardiac Symptoms in Adolescents: An Analysis of the Heartbytes Screening Registry

Abstract

Background: The ACC/AHA currently recommend performing a 14-point cardiovascular (CV) evaluation when screening healthy student-athletes for CV disease. This includes a focused history to assess for cardiac symptoms including exertional chest pain, dyspnea, fatigue, palpitations, and syncope. Though the presence of these symptoms may suggest underlying CV disease, additional factors including hours of weekly physical activity may influence the prevalence of reported symptoms. The relationship between physical activity level and the prevalence of cardiac symptoms has not been fully studied in an adolescent population. Methods: We analyzed the results of 10683 consecutive athlete screenings (median age 15 years) from HeartBytes, a data registry of pre-participation youth CV screenings utilizing the 14-point AHA evaluation. Cardiac symptoms and hours of weekly physical activity were self-reported. Weekly activity level was reported as less than 2 hours, between 2 and 5 hours, between 5 and 10 hours, or as greater than 10 hours. A chi-squared analysis for independence was performed to evaluate the relationship between physical activity level and each cardiac symptom. Results: Chest pain was reported in 5.1% of athletes, and increasing hours of physical activity was associated with less reported pain ( X 2 = 73.01, p <.001). Exertional dyspnea was reported in 11.7% of individuals, and increasing activity was associated with less reported dyspnea ( X 2 = 120.53, p <.001). Easy fatigability was reported in 7.5% of individuals, with more activity associated with less reported fatigue ( X 2 = 376.61, p <.001). Palpitations were reported in 5.1% of those screened, with increasing activity was associated with less reported palpitations ( X 2 = 95.34, p <.001). Finally, syncope was reported in 1.1% of athletes, though there was no relationship between activity level and syncope ( X 2 = 5.53, p = 0.24). Conclusion: Increased physical activity is associated with lower rates of reported chest pain, exertional dyspnea, easy fatigability, and palpitations in adolescents. Further studies are needed to clarify the relationship in youth athletes between symptoms and CV health.