Cardiac Auscultation in Sports Medicine

Abstract

Cardiac auscultation is an important part of the preparticipation physical examination of athletes. Sudden death remains a rare but tragic event among athletes. The most common cause of sudden death among young athletes in the United States continues to be hypertrophic cardiomyopathy, which may or may not present with a typical heart murmur. Many clinicians do not possess sufficient proficiency in recognizing abnormal heart murmurs. New insights in the field of auditory learning suggest that cardiac auscultation is more of a technical skill than an intellectual one. Intensive repetition of abnormal heart murmurs has been shown to improve proficiency in cardiac auscultation markedly. Sample audio files of two important murmurs, i.e., an innocent murmur and hypertrophic cardiomyopathy, are provided online with this review.

Athlete Preparticipation Physical Evaluation

“…Multiple studies have also shown the poor interobserver agreement in cardiac examination and referral practices 26,27. Strategies to improve recognition of pathologic cardiac murmurs during the PPE demonstrate the importance of practicing regular cardiac exams in the clinical setting 28. Cardiac screening also requires providers experienced in interpretation of electrocardiogram (ECGs) and echocardiograms, and available expertise from sports cardiologists, exercise physiologists, and radiologists who can interpret cardiac magnetic resonance imaging.…”