Hypertrophic cardiomyopathy screening

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Editors-In-Chief: C. Michael Gibson, M.S., M.D. [1], Cafer Zorkun, M.D. [2], Caitlin J. Harrigan [3], Martin S. Maron, M.D., and Barry J. Maron, M.D.

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Screening for hypertrophic cardiomyopathy

  • Screening for hypertrophic cardiomyopathy(HCM) is a controversial subject in the medical community, as HCM is the leading cause of sudden death in athletes.
  • AHA/ACC recommends that family history of the athlete should be sorted for any incidence of sudden death or presence of HCM in any of the family members.
  • If family history is positive, physical examination and echocardiography should be done.
  • In Italy, all competitive athletes are required to go through pre-participation screening of HCM
  • This particular program has been in existence since 1982, and screening generally includes:
    • 12-lead ECG
    • General and cardiovascular physical examination, including blood pressure measurements
    • Family history
  • Over 3 million competitive athletes are evaluated each year, and athletes judged to be free of cardiovascular disease receive a certificate enabling them to participate in competitive athleticsitalyref1
  • In a study done in Italy over a 9-year period (1990-1998), 4450 competitive athletes were screened for HCM. Based on echocardiographic evaluation, 4397 of the athletes were excluded from a clinical diagnosis of HCMitalyref1
    • 41 of the 4450 athletes showed LV hypertrophy, with increased wall thicknesses, with four athletes being on the border, with maximal LV wall thickness of 13 mm

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