PROSPECTIVE SCREENING OF 5,615 HIGH-SCHOOL ATHLETES FOR RISK OF SUDDEN CARDIAC DEATH

Sudden cardiac death among high school athletes is a very infrequent t hough tragic occurrence. Despite widespread preparticipation screening for known causes of this event, the frequency has not changed. The EC G is an acknowledged sensitive screening tool for the common causes of sudden cardiac death in young athletes. The specificity of the ECG in this setting is believed to be relatively low in young athletes for w hich reason, in part, it is not used. We added an ECG to the usual pre participation screening. An echocardiogram was performed when screenin g was abnormal. Outcome measures of serious or potentially serious car diovascular abnormalities were defined by the 16th Bethesda Conference . These abnormalities either preclude sports participation or require further testing before approval for participation in sports can be con sidered. Over 3 yr, 5,615 male and female high school athletes were sc reened prospectively from 30 different high schools in northern Nevada . Outcome measures were detected in 22 athletes or one per 255. Cardia c history led to detection of outcome measures in 0 athletes, ausculta tion/inspection in 1/6,000 athletes, blood pressure measurement in 1/1 ,000 athletes, and the ECG in 1/350 athletes. Specificity was 97.8% fo r an abbreviated cardiac history and auscultation/inspection and 97.7% for ECG. Overall, the ECG was a much more effective screening tool th an cardiac history and auscultation/inspection in detecting cardiovasc ular abnormalities requiring further tests before approval for partici pation in sports could be given. ECG and cardiovascular history/auscul tation/inspection had similar specificity ECG was efficiently performe d on large groups of high school athletes.