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Cardiovascular Disease |

Risk of Sudden Cardiac Death: A Novel Approach to Screen Student Athletes for Hypertrophic Cardiomyopathy

Medha Krishen; Mary Lynn Zaremba, MSN; Ajay Krishen; Sridhar Reddy, MPH
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St. Clair Pulmonary and Critical Care, Port Huron, MI


Chest. 2014;146(4_MeetingAbstracts):120A. doi:10.1378/chest.1989278
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Abstract

SESSION TITLE: Arrhythmia Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden death in individuals under the age of 35. We sought to develop a simple technique to screen student athletes for HCM. As sudden cardiac arrest is an important health issue amongst student athletes we attempted to design a screening test that can be easily implemented by school staff.

METHODS: Student athletes who had a normal cardiac sports physical and individuals with a definite diagnosis of HCM completed a questionnaire regarding symptoms and risk factors for HCM. Using an electronic stethoscope, cardiac sounds were recorded over a five second period and a Fast Fourier analysis was performed. The recording was done in a lying down position, standing and after exercise. Frequency peaks of a frequency amplitude plot were analyzed. The data was statistically analyzed using standard T-test and analysis of variance.

RESULTS: There was a significant difference between the distribution of frequency peaks in the two groups between the lying down position and post exercise. The normal athletes (n=10) showed a lower percentage of peaks above 131 Hz after exercise, 27.8% lying down and 5.86% post exercise. The opposite was seen with a rise in frequency peaks in patients with HCM (n=3), 14.07% lying down and 26.38% post exercise. There was a significant difference in the change of the number of peaks above 131 Hz before and after exercise between the two groups. The change in peaks for the control group was 21.942 +/- compared to -12.313 +/- this difference was statistical significant (p=.00195).

CONCLUSIONS: In a school health setting a short recording by an electronic ear can potentially be used to screen for HCM.

CLINICAL IMPLICATIONS: Every year, at least 100 young athletes die of sudden cardiac arrest in the United States. HCM is the most common cause of sudden cardiac arrest under the age of 35. Early detection of HCM in student athletes is key to preventing sudden cardiac death. Our study, by analyzing heart sound frequencies may be a useful technique that can be implemented by school staff to screen for HCM. Its use in other public health settings can result in a significant impact in preventing sudden cardiac death.

DISCLOSURE: The following authors have nothing to disclose: Medha Krishen, Mary Lynn Zaremba, Ajay Krishen, Sridhar Reddy

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