CARDIOVASCULAR SCREENING - TAILORING THE PREPARTICIPATION EXAM

While the critical task of the preparticipation cardiac examination is identifying life-threatening conditions, care must be taken not to ex clude healthy individuals from activity. The vast majority of exams wi ll be negative, but the physician should be alert to such potentially lethal conditions as hypertrophic cardiomyopathy, aortic stenosis, and Marfan syndrome. A history of symptoms during exertion, certain featu res of physical appearance, and clinical findings require referral to a cardiologist. Although the cardiac examination needn't involve compl ex tests, it must permit recognition of abnormal heart sounds and othe r signs of pathology. In the older athlete, coronary heart disease is the principal risk, and the examination should be tailored accordingly .