A PPE should include the taking of a complete medical history on the following:

Heart

1. Family medical history. Has anyone in the athlete's family:

• Died for no apparent reason (SIDS, car accident, drowning)?

• Have a heart problem?

• Died of heart problems or sudden cardiac arrest before age 50?

• Had syncope (fainting) or presyncope (near fainting)?

• Had unexplained seizures?

• Had significant arrhythmia (irregular heartbeat) or a pacemaker?

• Had any of the following genetic disorders:

• Hypertrophic cardiomyopathy (HCM). Note, however, that one study found that only 25% of athletes with HCM who died of sudden cardiac death had a family history of one or more nontraumatic familial deaths at age 50 or younger.

• Dilated cardiomyopathy (DCM)

• Marfan syndrome

• Ehlers-Danlos syndrome

• Arrythmogenic right ventricular cardiomyopathy

• Early coronary artery disease

• Brugada syndrome

• Long QT syndrome (LQTS)

• Short QT syndrome

• Primary pulmonary hypertension

• Rheumatic fever

• Hypertension (high blood pressure) or

• Kawaski disease?

2. Personal Medical History

• Has the child ever experienced:

• Chest pain with or without exercise?

• Excessive, unexpected, or unexplained fatigue with exercise?

• Excessive, unexpected, or unexplained shortness of breath with exercise? (Note: doctors don't always recognize this as a symptom of congenital heart disease, sometimes mistaking it for exercise-induced asthma. In one case, a 15-year-old boy was pulled out of a soccer game because of shortness of breath and later diagnosed with asthma. A month later, he suffered sudden cardiac death on a soccer field as a result of HCM)

• Heart palpitations (heart races or skips beats) during exercise?

• Past detection of a heart murmur or high blood pressure?

Skin (warts, fungus, blisters, boils or skin infections)

Neurologic

• Has the athlete experienced or is he experiencing:

• Headaches

• Seizures

• Post-concussion symptoms

• History of concussions

Heat illness

Asthma and Seasonal Allergies

Asthma should be suspected in any athlete with a history of wheezing during sports

Weight concerns (i.e. eating disorders)

Psychosocial Issues

Alcohol, drugs, tobacco, steroids, and sexual practices

Menstruation

Primary amenorrhea (absence of periods by age 16) or secondary amenorrhea (absence of period for more than three cycles) indicate the likely presence of the female athlete triad

Article created June 25, 2007
© 2007 MomsTeam.com, Inc.

About the Author:
Brooke de Lench is the author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (Harper Collins 2006) and the founder and Editor-in-Chief of MomsTeam.com.

Pre-Participation Evaluations: A Primer for Parents

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