Does echocardiography provide incremental diagnostic value over physical examination (auscultation) during pre-participation screening in young athletes?
Echocardiography should be considered alongside physical examination in young athletes to prevent missing silent pathologies and avoid false-positive diagnoses from auscultation alone.
Purpose: The goal of our study was to find an association between auscultatory and echocardiographic findings and to determine diagnostic value of each of these methods. Methods: 186 soccer players (13 to 16 years of age) underwent pre-participation screening, including physical examination and echocardiography with color doppler. Results: The study revealed that 17.1% of all investigated persons had neither auscultatory nor echocardiographic abnormalities. Simultaneous auscultatory and echocardiographic changes were observed in 43.8% of all investigated athletes (including systolic murmurs, accentuation of second heart sound, mitral regurgitation, mitral valve prolapse, tricuspid regurgitation and etc). Only auscultatory changes, not visible on echocardiographic examination, were observed in 30.1% of athletes. 8.9% of athletes had only echocardiographic changes, including two cases of mitral valve prolapse and regurgitation, requiring further assessment and observation. Conclusion: Obtained results demonstrate considerably high frequency of auscultatory and echocardiographic changes among young athletes. Furthermore, rate of discordance between the findings obtained by two different methods is almost as high (39.0%), as rate of concordance between them (43.8%). Therefore, we suggest that it is desirable to conduct echocardiographic examination along with physical examination of athletes, in order to exclude possibility of overlooking relatively severe pathologies on one hand, and to avoid false positive diagnosis of valvular disease, on the other hand.
Svanishvili et al. (Fri,) studied this question.