Table 1 The 14-element AHA recommendation for pre-participation cardiovascular screening of competitive athletes
From: Routine pre-employment echocardiography assessment in young adults: cost and benefits
Medical history (parental verification recommended for high school and middle school athletes) | |
Personal history | 1.Exertional chest pain/discomfort |
2.Exertional syncope or near-syncope | |
3.Excessive exertional and unexplained fatigue/fatigue associated with exercise | |
4.Prior recognition of a heart murmur | |
5.Elevated systemic blood pressure | |
6.Prior restriction from participation in sports | |
7.Prior testing for the heart ordered by a physician | |
Family history | 8.Premature death–sudden and unexpected before age 50 year due to heart disease, in one or more relatives |
9.Disability from heart disease in a close relative < 50 years old | |
10.Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy, long QT syndrome or other ion channelopathies, Marfan syndrome, or clinically important arrhythmias | |
Physical exam | |
11. Heart Murmur—exam supine and standing or with Valsalva, specifically to identify murmurs of dynamic L ventricular outflow tract obstruction | |
12. Femoral pulses to exclude aortic stenosis | |
13. Physical stigmata of Marfan syndrome | |
14. Brachial artery blood pressure (sitting, preferably taken in both arms) | |