Heart Disease in Children: Cardiac Preparticipation Evaluation

The purpose of the cardiac portion of the preparticipation physical evaluation is to identify potential health risks in young athletes, particularly sudden cardiac death. The preparticipation evaluation begins with a detailed screening questionnaire. Sudden cardiac death in athletes is considered rare, but the incidence in athletes is higher than in the general population. Leading causes of sudden cardiac death include hypertrophic cardiomyopathy, coronary artery anomalies, myocarditis, arrhythmogenic right ventricular cardiomyopathy, and aortic dissection. It also can be due to ventricular fibrillation, sometimes preceded by ventricular tachycardia. Electrocardiogram results may be abnormal in athletes who are at risk for sudden cardiac death, but diagnosis is made using cardiac imaging. Guidelines exist with recommendations for return to play for athletes who are at risk for sudden cardiac death.