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Annual preparticipation cardiovascular screening of athletes is a generally accepted practice.1,2,3 The main objective of the screening is to identify risk factors that predispose a previously asymptomatic and apparently healthy athlete to sudden cardiac arrest and death.

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History

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History is the most important aspect of cardiovascular screening of young athletes. The history has been shown to have the most yield for identifying potential risk factors for adverse cardiac outcome. The key elements of cardiovascular screening history are summarized in Table 14-1.14

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Table 14-1. Cardiovascular Screening History 
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Physical Examination

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A general physical examination may reveal some important clues to cardiovascular disease, exemplified by the wide ranging clinical features seen in Marfan syndrome (Table 14-2).5 Key elements of cardiovascular examination are summarized in Table 14-3. Heart murmurs are a common finding in children and adolescents and it is important to appropriately distinguish the benign from pathologic murmurs that will indicate need for further evaluation. A simple classification of heart murmurs is presented in Table 14-4, the effects of certain physiologic maneuvers on cardiac auscultatory events are summarized in Table 14-5, and clinical clues that help identify benign heart murmurs are summarized in Table 14-6.4,6

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Table 14-2. Criteria for Marfan Syndrome 

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