(See also Sudden Cardiac Death in Athletes.)
Screening for all children and adults should include a thorough cardiovascular history, with questions about
Physical examination should routinely include BP in both arms, supine and standing cardiac auscultation, and inspection for features of Marfan syndrome. These measures aim to identify adults as well as rare, apparently healthy young people at high risk of life-threatening cardiac events (eg, people with arrhythmias, hypertrophic cardiomyopathy, or other structural heart disorders).
Testing is directed at clinically suspected disorders (eg, exercise stress testing for coronary artery disease, echocardiography for structural heart disease, ECG for arrhythmia or long QT syndrome). Routine stress testing in the absence of symptoms, signs, or risk factors is not recommended.
Other screening measures:
Noncardiovascular risk factors are more common than cardiovascular risk factors. Adults are asked about the following:
Two populations at risk for injuries are commonly overlooked:
Adolescents and young adults should be asked about use of illicit and performance-enhancing drugs. (See also the US Anti-Doping Agency web site.www.usantidoping.org.)
In girls and young women, screening should detect delayed onset of menarche. Girls and young women should be screened for the presence of the female athlete triad (eating disorders, amenorrhea or other menstrual dysfunction, and diminished bone mineral density). Two questions are validated screening measures for eating disorders:
There are almost no absolute contraindications to sports participation.
Exceptions in children include
Exceptions in adults include
Relative contraindications are more common and lead to recommendations for precautions or for participation in some sports rather than others, for example:
Last full review/revision October 2014 by Jack T. Andrish, MD
Content last modified October 2014