Objectives: To evaluate the incidence and the clinical significance of the cardiologic abnormalities detected in candidates to competitive sports.
Design: Retrospective study of candidates to competitive sports who were evaluated for heart fitness.
Setting: Out patient cardiologic clinic in a Center of Sports Medicine in Lisbon.
Patients and methods: 420 subjects out of a population of 6795 were followed up for one year. They underwent clinical evaluation with ECHO (M mode, 2D, Doppler), 24 hours Holter monitoring and Exercise Tests as indicated for decision concerning fitness and adequacy for the practice of competitive sports.
Results: Main reason for observation was the assessment of the significance of cardiac murmur (265; 6.3%). 14 cases of organic heart disease were diagnosed: 9 bicuspid aortic valves (2 with systolic gradient over 40 mmHg), 2 with atrial septal defects, 2 significant mitral valve prolapse and 1 ventricular septal defect. 86 patients were evaluated because of ECG abnormalities; 26 out of these presented ventricular ectopic beats, 6 had delayed AV conduction (PQ > 0.24 sec), 44 developed non specific STT changes and 16 a pre-excitation (WPW) tracing. Holter studies demonstrated 8 cases of complex ventricular premature beats and one case of paroxysmal atrial tachycardia. Arterial hypertension was the reason for evaluation of 20 athletes, 5 of whom were considered unfit due to hypertensive response to effort and/or systemic involvement.
Conclusions: The evaluation of heart murmurs was the principal reason to evaluate candidates to the practice of sports. The large majority were considered innocent murmurs. Ventricular premature beats, non specific repolarization changes and pre-excitation (WPW) were the predominant electrocardiographic abnormalities. There was a remarkably low incidence of organic heart disease in the latter group. The most common reasons to declare unfitness for competitive sports practice were repetitive ventricular ectopic beats and arterial hypertension.