Objective: Sudden cardiac death in young athletes is relatively uncommon and is usually caused by occult underlying cardiovascular disease. Studies have indicated that preparticipation screening may reduce the incidence of sudden death. Our aim was to study the feasibility of standardized preparticipation screening in young competitive Icelandic athletes. The prevalence of risk factors was studied in order to evaluate how often further examination is indicated and to assess possible costs.

Material and methods: A total of 105 randomly selected competitive athletes (70 men, 35 women) between the age 18-35 received standard screening with medical history, cardiac examination and 12 lead ECG.

Results: The most frequent complaints revealed by medical history were allergy, excema, asthma, dyspnea on exercise, chest pain on exercise, palpitations on exercise, dizziness and fainting on exercise. Physical examination was abnormal in 20 (19%). 12 lead ECG was distinctly abnormal in 22 (21%) and mildly abnormal in 23 (22%). Transthoracal echocardiography (TTE) was performed on 19 (18%). Of those, TTE was normal  in six athletes (32%) and mildly abnormal in 13 (68%), none had abnormal findings indicating structural heart disease.

Conclusion: Symptoms associated with cardiac disease are frequently described among young athletes. Abnormal ECG was commonly found. Further examination with echocardiography may be indicated in one of every four athletes screened.

Thorolfsson B, Thordardottir FR, Gunnarsson GTh, Sigurdsson AF

¹University of Iceland, ²University Hospital of Iceland, ³Hospital of Akureyri, ⁴Center for Heart Dieases.

Table I. Sports distribution of the athletes.

Table II. Results from questionnaire on family history. Only first degree relatives were included.

Table III. Results from questionnaire on clinical symptoms.

Table IV. Results from questionnaire on medical history.

Table V. Results from cardiac examination.

Table VI. Results from ECG analysis.

Table VII. Underlying ECG changes which determined classification.

Table VIII. Results from ECG classification in athletes with risk factors on cardiac examination.

Table IX. Results from echocardiography in 19 athletes with positive risk factors on cardiac examination, ECG or questionnaire.