MiscellaneousLessons Learned from Preparticipation Cardiovascular Screening in a State Funded Program
Section snippets
Methods
In 2007, the Texas State legislature approved Senate Bill 7, relating to the placement of automated external defibrillators in schools statewide. Section 38.109 of this bill allocated 1 million dollars for the Texas Education Agency to “establish a pilot program under which students are administered cardiovascular screening, including an electrocardiogram and an echocardiogram.” To implement this screening program, a collaborative group of investigators was formed with regional centers in
Results
A total of 28 events were present for model 1, averaging 72.2 students/event. On average, the ECGs were interpreted 82.5 days after the screening venue, the echocardiograms were read 28.6 days after the venue, and the study results were mailed to the participants 89.5 days after the venue. In model 2, 3 events occurred, averaging 161.3 students/venue. In this latter model, the screening results were provided immediately to the participant.
A total of 2,506 students were enrolled, with 2,022
Discussion
Although nationwide acknowledgment and agreement exists among experts regarding the importance of preventing SD in youths and adolescents, consensus is lacking regarding the methods to achieve this goal. A significant impediment is inadequate data regarding the feasibility and efficacy of a large-scale screening process. The present study is the first large, prospective and fully state-funded screening initiative to identifying the potential causes of young athlete SD. Others have reported
Acknowledgment
We appreciate Janet Smith, BA, and Ellen Suen, MS, for their assistance with the database development and organization, and Joan Reisch, PhD, MS, for her assistance with the biostatistical analysis and database development. We also thank Ben Eidem, MD (Mayo Clinic, Rochester), for his willingness to independently review the study echocardiograms.
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2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease
2021, Revista Espanola de CardiologiaDetection and Management of Heart Disease in Athletes
2020, Primary Care - Clinics in Office PracticeCitation Excerpt :Limitations of the H&P include its general, nonspecific symptom questions, yielding a high rate of positive responses, and its reliance on accurate and truthful reporting by the athlete.50 Positive response rates to at least 1 symptom or family history question have been reported in 30% to 36% of high school and college athletes.51–54 Although history questionnaires yield a high number of positive responses that can be difficult to clarify, certain H&P clues must never be discounted.
Sudden Death and Ventricular Arrhythmias in Athletes: Screening, De-Training and the Role of Catheter Ablation
2019, Heart Lung and CirculationCitation Excerpt :There is little evidence supporting the use of echocardiography for routine screening. Zeltser et al. provide some insight into the potential limitations of a pre-participation screening program inclusive of an echocardiographic examination [25]. They screened 2,051 high-school athletes with a ‘limited’ echocardiographic examination comprising two-dimensional measures of cardiac structure, volumes and ejection fraction;14 athletes (0.7%) were considered to have changes on echocardiogram suspicious of disease (10 HCM, one non-compaction and one DCM) — all but three of which had ECG changes that would have prompted further evaluation in any case.
Multimodality Imaging in Individuals With Anomalous Coronary Arteries
2017, JACC: Cardiovascular ImagingCitation Excerpt :Most children have excellent transthoracic acoustic window, thus TTE is often arguably the most valuable diagnostic tool for ACA in children without the need for additional imaging (2,35,39,40). In adults or those with limited transthoracic acoustic window, TTE is only of limited value (41) and transesophageal echocardiography is more sensitive than TTE in identifying ACA and the associated anatomic high-risk features. Transesophageal echocardiography provides superior sensitivity for assessing the vessel course than TTE (33).
Is Echocardiography Adequate to Identify the Severity of Anomalous Coronary Arteries?
2016, JACC: Cardiovascular ImagingBenign and pathological electrocardiographic changes in athletes
2015, Revista Portuguesa de Cardiologia
This project was funded by RFP number 701-08-027 from the Texas Education Agency (Austin, Texas).