Screening and Contraindication Checklist for Sports Participation

Feb 23, 2018 • Mark Morgan

categories: Pediatrics Subjective/History

Screening and Contraindication Checklist for Sports Participation
Personal History
Exertional chest pain/discomfort Unexplained syncope/near-syncope Excessive exertional and unexplained dyspnea/fatigue, associated with exercise Prior recognition of a heart murmur Elevated systemic blood pressure

Family History
Premature death (sudden and unexpected, or otherwise) before age 50 years due to heart disease, in 1 or more relatives Disability from heart disease in a close relative less than 50 years of age Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy, long-QT syndrome or other ion channelopathies, Marfan syndrome, or clinically important arrhythmias

Physical Examination
Heart murmur Femoral pulses to exclude aortic coarctation Physical stigmata of Marfan syndrome Brachial artery blood pressure (sitting position)

Contraindications for Sports Participation
Active myocarditis or pericarditis
Hypertrophic cardiomyopathy Severe hypertension until controlled by therapy (static resistance activities, such as weight lifting, are particularly contraindicated) Suspected coronary artery disease until fully evaluated (patients with impaired resting left ventricular systolic function less than 50%, or exercise-induced ventricular dysrhythmias, or exercise-induced ischemia on exercise stress testing are at greatest risk of sudden death) Long QT interval syndrome History of recent concussion and symptoms of postconcussion syndrome (no contact or collision sports) Poorly controlled convulsive disorder (no archery, riflery, swimming, weight lifting or power lifting, strength training or sports involving heights) Recurrent episodes of burning upper-extremity pain or weakness, or episodes of transient quadriplegia until stability of cervical spine can be assured (no contact or collision sports) Sickle cell disease (no high-exertion, contact or collision sports) Eating disorder where athlete is not compliant with therapy and follow-up, or where there is evidence of diminished performance or potential injury because of eating disorder Acute enlargement of spleen or liver

display/hide references
reference:
#1 Maron BJ, Thompson PD, Ackerman MJ, Balady G, Berger S, Cohen D, Dimeff R, Douglas PS, Glover DW, Hutter AM Jr, Krauss MD, Maron MS, Mitten MJ, Roberts WO,
Puffer JC; American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology
Foundation. Circulation. 2007 Mar 27;115(12):1643-455.
#2 Kurowski K, Chandran S. The preparticipation athletic evaluation. Am Fam
Physician. 2000 May 1;61(9):2683-90, 2696-8.

Screening and Contraindication Checklist for Sports Participation

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