Abstract
BackgroundConventional echocardiography is a safe, available, and accurate tool for cardiac structural and functional evaluation, but it should not cancel clinical assessment and history tacking, and indeed both are complementary. A pre-employment assessment is important for employees and community safety and suitability for a specific work requirement.ResultsAiming to assess the value of routine pre-employment echocardiography for the detection of cardiac abnormalities, we examined seven hundred ninety-five persons who were routinely referred to us for pre-employment conventional echocardiography. Only 9 persons had structural cardiac abnormalities (1.3%) and distributed as follows: two had bicuspid aortic valve with isolated aortic regurgitation, one of them had mild AR, and the other had moderate AR. Two cases had mitral valve prolapse, one of them had trivial MR, while the other had a flail anterior leaflet with severe MR. One patient had atrial septal defect 1.5 cm with mild pulmonary hypertension and right-sided chambers dilatation. One patient had dextrocardia (situs inversus totalis) without other cardiac problems. One had moderate pulmonary hypertension and modest right-sided chambers dilation. Two patients had left ventricular hypertrophy. Surprisingly, we did not detect rheumatic valvular heart disease. The money cost of echocardiography tests for those 795 persons was 198,750 Egyptian pounds (LE); their transportation cost was about 19.800LE. The total group time cost of the tests was 265 h, total time lost at the waiting room was 1590 h, total transportation time lose was 2385 h, so the total time cost was about 4000 h. Using psychological stress questionnaire, 33 participants (4.2%) had results suggestive of a low sense of psychological pressure due to echocardiography examination, 221 participants (27.8%) had results suggestive of a moderate feeling of stress, while 541 participants (68%) had results suggestive of a high sense of stress.ConclusionWe recommend against routine echocardiography for cardiac assessment in pre-employment assessment and to do it only for persons with abnormal clinical or ECG findings.
Highlights
Conventional echocardiography is a safe, available, and accurate tool for cardiac structural and functional evaluation, but it should not cancel clinical assessment and history tacking, and both are complementary
The leading cause of sudden cardiac death is well known which is a cardiovascular disease as silent ischemic heart disease, lethal arrhythmias, and myocardial diseases as hypertrophic cardiomyopathy, so early detection, diagnosis, and proper management of silent cardiovascular diseases are of great importance [3]
We did not find a questionnaire focusing on psychological stress induced by peemployment medical assessment, so we developed the Pre-employment psychological Stress Scale (PSS) to assess and escalating the psychological stress induced by pre-employment medical assessment (Table 2)
Summary
Conventional echocardiography is a safe, available, and accurate tool for cardiac structural and functional evaluation, but it should not cancel clinical assessment and history tacking, and both are complementary. A pre-employment assessment is important for employees and community safety and suitability for a specific work requirement. The medical examination offers several purposes for the benefit of the employer and the employee. It is done to ensure that the prospective employee has no “serious medical condition” and he is “physically and mentally” suitable for the job offered. The demands of the work requirements that the prospective employee should meet the minimum required medical standards to qualify for the appointment [1]. Despite the argument about the practical benefits of screening tests, there is a true desire to screen populations under cardiovascular risk; the screening aims to detect underlying diseases or abnormalities and subsequently reduce morbidity and mortality, but there is no agreement about the most proper and reliable test which can effectively detect the disease or abnormalities [2].
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Schedule a callMore From: The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology
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