Evaluation of Children Referred to the Pediatric Cardiology Outpatient Clinic for Preparticipation Sports Examination

Abstract

Introduction: The number of patients who apply to cardiology outpatient clinics to get a medical certificate in order to participate in sports is increasing day by day. This study was carried out to evaluate the characteristics and cardiological examination results of the cases who applied to the pediatric cardiology outpatient clinic in a period of one year. Methods: Demographic characteristics, personal and family history, blood pressure (BP), electrocardiogram (ECG) and echocardiogram (echo) results of children who applied to our center for participation in sports between 01.01.2019 and 31.12.2019 from the pediatric cardiology outpatient clinic records and whose ICD code was entered into the system accordingly, were retrospectively analyzed. Results: The study group consisted of 468 children and adolescents. Of the cases, 312 (67%) were male and 156 (33%) were female. Their mean age was 11.33 (min:3, max:17, n=468). Their mean body weight was 47.35 kg (min:18, max:93, n=147) and their mean height was 152.62 cm (min:112, max:188, n=147). While 104 (22%) of the cases had a history that could affect sports activity, 364 (78%) did not. While there was a family history that might affect their ability to do sports in 123 (26%) cases , there was no cause in 345 (74%) cases. The mean systolic BP values of the cases were 110 mmHg (min:82, max:171), and the mean diastolic BP values were 68 mmHg (min:40, max:90). On ECG examinations, 1 case had extrasystole and 1 had Wolf-Parkinson-White syndrome. The mean QTc interval values were 414.88 ms (min: 350, max: 467). In addition to the examination, exercise stress test, ambulatory BP monitoring or BP monitoring, Holter monitoring were requested in 78 of the cases (17%). Echo evaluation revealed pathology in 26 cases (5.5%). Twenty-five of these pathologies were insignificant pathologies, and 1 of them was a cardiac pathology that would affect performing sports acitivities. Nine of the children (1.9%) were not given a medical certificate to do sports. Four of them were referred to the arrhythmia outpatient clinic. Discussion and Conclusion: When the cardiology examination findings in the study were evaluated, it was determined that the rate of cardiac pathology that would affect doing sports was very low. Most of the cases were cases that could be evaluated in primary and secondary health care institutions with a good anamnesis, physical examination, ECG and BP monitoring. Standardizing such preparticipation examinations according to a guideline will be beneficial both for obtaining objective results and for ensuring the physician's safety and convenience.