Cardiovascular abnormalities in the athlete: recommendations regarding eligibility for competition. Task force I: Congenital heart disease

Daily physical activity and perception of condition severity among male and female adolescents with congenital heart malformation

The purpose of this study was to examine among young patients with congenital heart malformation (CHM) the concordance between a cardiologist's definition of the severity of malformation and recommendations regarding physical activity and the patients' perceptions of their condition. Subjects included male (n = 55) and female (n = 45) adolescents aged between 12 and 18 years who have trivial (38%), mild (21%), or moderate (41%) CHM. Thirty-one percent of the patients rated their CHM as less severe whereas 15% rated their CHM as more severe than the cardiologist's definition. Although most patients engaged in physical activity appropriate for their condition, a noteworthy percentage engaged in activities more intense than those recommended by the patient's personal cardiologist.

Fatal cardiac arrest following blunt chest trauma 17 years after a Senning operation

Although frequent in patients who have undergone Senning or Mustard operations, cardiac arrhythmias after blunt chest trauma have not been reported. We report the case of a 17-year-old boy with ventricular fibrillation after a minor blow to the chest.

Sudden cardiac death in infants, children, and adolescents

Although SCD is relatively uncommon, its psychosocial impact is devastating. This article has reviewed the potential causes of SCD in infants, children, and adolescents. Many patients who die from SCD have identifiable cardiac disease and are known to have been at risk; however, the existence of other cardiac abnormalities, such as hypertrophic cardiomyopathy or long QT syndrome, may not be known, and SCD may be the first symptom. The authors' contention is that many of the patients in this latter group (e.g., patients who have hypertrophic cardiomyopathy or LQLTS but who have no symptoms) can be screened with a careful, accurate, and detailed history, including family history and review of systems, and physical examination. Any patient with a positive family history, positive review of systems, or positive physical examination should receive further in-depth evaluation, such as an ECG and echocardiogram. These studies permit the detection of most, if not all, of the entities potentially associated with SCD in the pediatric population.

The tall athlete and Marfan syndrome. Need for clinical differentiation

A 14-year-old female athlete was referred because of her height, thinness, and long fingers. Investigation suggested that she did not have Marfan syndrome, but rather mitral valve prolapse. This case presentation demonstrates some of the difficult issues faced in sports medicine when dealing with athletes suspected of the Marfan syndrome or mitral valve prolapse.