INCORPORATION OF SCREENING ECHOCARDIOGRAPHY IN THE PREPARTICIPATION EXAM

We sought to evaluate the economic aspects and benefits of adding a li mited screening echocardiogram to our annual athletic preparticipation examinations. It was our belief that this screening echocardiogram wo uld add valuable information beyond the history and physical exam alon e and could be included in our station-by-station format with little i ncrease in time or cost. Controversy exists concerning the best method of detecting cardiovascular conditions that may predispose the athlet e to sudden death. During our 1992 preparticipation examinations, we i ncluded a single-view parasternal long- and short-axis two-dimensional screening echocardiogram. This screening can detect four potentially fatal congenital heart defects. We performed a total of 2,997 echocard iograms at an average cost of $7.34 per examination. Overall 64 echoca rdiographic abnormalities were found. Mitral valve prolapse and bicusp id aortic valve were the two most common abnormalities. The sensitivit y of the history and physical examination in detecting cardiovascular abnormalities was extremely low. Incorporating the echocardiogram into our station-to-station format did not add a significant amount of tim e to the overall process. We conclude that a screening echocardiogram provides important information and can be used efficiently and economi cally in the athletic preparticipation examination.