ECHO 2013 / Echo and the Athlete’s heart
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BC#36 recommendations
•(+)Bicuspid Aortic valve without aortic root dilatation and no sig AS/AR may participate in all competitive sports
•(+)BiAV with dilated aortic root 40-45mm can participate in low and mod static or low and mod dynamic competitive sports, but should avoid any sport with potential for bodily collision or trauma
•(+)BiAV and aortic root >45mm should participate in only low intensity competitive sport
Marfan’s criteria (2010 revised Ghent nosology)
•(-) FH: any one
•Aortic criterion AND ectopia lentis
•Aortic criterion AND FBN1 mutation
•Aortic criterion AND systemic score >7
•Ectopia lentis AND FBN1 mutation
•(+) FH:
•Ectopia lentis
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Systemic score >7 |
24 year old with lens |
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Aortic criterion (Z>/=2 above 20 |
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years old , Z>/=3 below 20 years old, dislocation, (+)FH Marfan’s |
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or aortic dissection)
2.6cm
4.5cm
4.5cm at sinuses of Valsava= Z score of 4.25
Can he participate in sports?
Based on aortic root dimensions with close monitoring by echo q6 months can participate in low and mod competitive sports if following features absent:
•aortic root dilatation. transverse dimension >/=40mm, or Z score >2.0
•mod to severe MR
•family history of aortic dissection or sudden death
Cost of ECG screening in US Halkin et al. JACC 2012. 60(22)
•ECG screening in US would cost up to $69billion over 20 years and save 4,813 lives. Price per life saved $10million dollars. Not actual cost of tests.
Vs.
•Italian National Pre participation screening package cost per athlete is $60