Abstract
Objectives
We assessed the diagnostic yield and costs of an electrocardiogram-based national
screening programme in elite cricket players and the incremental value of transthoracic
echocardiography and periodic evaluation.
Design
Cross-sectional study.
Methods
Between 2008 and 2019, 1208 cricketers underwent screening with a health questionnaire,
12-lead electrocardiogram and cardiology consultation. Athletes with concerning findings
underwent on-site transthoracic echocardiography and further investigations as necessary.
In addition, despite a normal health questionnaire and electrocardiogram, 342 (28.3%)
athletes had a transthoracic echocardiogram and 493 (40.8%) underwent repeat evaluations.
Results
After initial evaluation, 47 (3.9%) athletes underwent on-site transthoracic echocardiography
of whom 35 (2.8%) were referred for further evaluation. Four athletes (0.3%) were
diagnosed with major cardiac conditions; hypertrophic cardiomyopathy (n = 1), arrhythmogenic
cardiomyopathy (n = 1) and Wolff-Parkinson-White pattern (n = 2). Two athletes were
identified with minor valvular abnormalities. Repeat evaluation of 493 athletes identified
hypertrophic cardiomyopathy in a 22-year-old athlete, two years after his initial
normal screening. During a follow-up of 5.8 ± 2.9 years no additional diagnoses or
adverse cardiac events were reported. The cost of the electrocardiogram-based programme
was £127,844, translating to £106 per athlete and £25,569 per major cardiac condition
identified.Routine transthoracic echocardiography in 342 athletes identified two athletes
with major cardiac conditions (bicuspid aortic valve with severe aortopathy and aortic
regurgitation and an atrial septal defect associated with right ventricular volume
overload) and 10 athletes with minor abnormalities.
Conclusions
An electrocardiogram-based national screening programme identified a major cardiac
condition in 0.3% of athletes. Routine transthoracic echocardiography and periodic
evaluation increased the diagnostic yield to 0.6%, at an incremental cost.
Keywords
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Article info
Publication history
Published online: December 07, 2021
Accepted:
December 5,
2021
Received in revised form:
November 30,
2021
Received:
September 15,
2021
Identification
Copyright
© 2021 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
