The preparticipation sports examination. Cardiovascular considerations for screening.

Physicians performing cardiovascular screening examinations in young and adult athletes should be aware of the rarity of exercise complications and the difficulty in separating cardiac adaptations to training from pathologic conditions. Coronary artery disease is the predominant cause of cardiac events during exercise in adults, whereas congenital abnormalities are the primary cause of exercise deaths in children. The preparticipation cardiac examination should include blood pressure measurements, visual inspection for the Marfan habitus, and auscultation designed to detect ventricular outflow obstruction. Other cardiovascular testing should be used when symptoms or findings warrant further evaluation.