Usefulness of Focused Screening Echocardiography for Collegiate Athletes.

Sudden cardiac death in a young healthy athlete is a rare but catastrophic event. The American Heart Association preparticipation screening guidelines recommend a focused history and physical without routine imaging or electrocardiogram screening. We hypothesized that a focused echocardiogram can identify structural abnormalities that may lead to sudden cardiac death in athletes, which might otherwise go undetected by history and physical.

The 5-minute screening echocardiogram for athletes.

Background: Echocardiography is an accurate way to identify common cardiac abnormalities that lead to sudden death. We report a screening echocardiogram protocol incorporated into the routine athletic medical assessment for all incoming college freshman athletes.

Methods: A limited 2-dimensional echocardiogram was performed on athletes as part of a routine sports physical examination.

Survey of current practices of the specialty of physicians interpreting cardiac and noncardiac findings of coronary computed tomographic angiography.

Computed tomographic angiography, as an imaging modality to evaluate the coronary arteries, has been rapidly expanding since the release of 64-slice machines. Little is known about current practice patterns. This study was conducted to evaluate current practice patterns and views regarding the interpretation of noncardiac findings by distributing a survey to the approximately 800 attendees of the first annual meeting of the Society of Cardiovascular Computed Tomography in 2006.

Does detection of carotid plaque affect physician behavior or motivate patients?

Background: Imaging techniques to identify subclinical atherosclerosis are becoming more widespread, but few data exist regarding their influence on patient or physician behavior. We evaluated the impact of ultrasound screening to identify carotid artery plaques on physician treatment plans and patient motivation.

Methods: Subjects included asymptomatic patients without known vascular disease who had 2 or more cardiac risk factors.

An abbreviated carotid intima-media thickness scanning protocol to facilitate clinical screening for subclinical atherosclerosis.

Background: Carotid intima-media thickness (CIMT) testing can assist with cardiovascular risk prediction; however, the requirement for rigorous, time-consuming protocols has limited it use in clinical practice.

Methods: Bilateral images of the common carotid artery (CCA), bulb, and internal carotid artery segments were obtained using a comprehensive scanning protocol. Three abbreviated scanning protocols were evaluated for their ability to identify patients with increased CIMT (> or = 75th percentile).

Patchy myocardial fibrosis 20 years after radiation therapy.

We describe a case of a young woman diagnosed with Ewings sarcoma at age 8 and treated with adriamycin and radiation therapy. Twenty years later the patient has a cardiomyopathy and a focal area of patchy infiltration of fibrotic tissue along the left ventricle and atrium. Although fibrosis due to radiation exposure has been demonstrated on biopsy and autopsy studies, we are not aware of previous reports of echocardiographic demonstration of this finding.

Is the ankle-brachial index a useful screening test for subclinical atherosclerosis in asymptomatic, middle-aged adults?

Background: Measurement of the ankle-brachial index (ABI) is recommended as a screening test for cardiovascular risk prediction in individuals > or = 50 years old; however, there is little data regarding the utility of the ABI as a screening test in individuals for whom physicians actually order non-invasive testing for cardiovascular risk prediction.

Methods: This study included 493 consecutive asymptomatic patients without known atherosclerotic vascular disease who were referred by their physician for measurement of the ABI and ultrasound measurement of carotid intima-media thickness (CIMT). ABI values were classified as "reduced" (<0.

Use of carotid intima-media thickness and vascular age to modify cardiovascular risk prediction.

Background: This study identified predictors of patients for whom carotid artery intima-media thickness (CIMT) measurement and determination of vascular age could change cardiovascular disease (CVD) risk assessment.

Methods: We studied consecutive patients who were asymptomatic and nondiabetic, referred for ultrasound measurement of CIMT. Individuals with CIMT 75th percentile or greater for age, sex, and race were defined as having advanced subclinical atherosclerosis.

Ultrasound-detected carotid plaque as a predictor of cardiovascular events.

Ultrasound detection of carotid plaque can be performed with equipment that is available in many clinical settings and can identify patients at increased risk of cardiovascular (CV) disease. We reviewed the literature to determine the CV risk factors associated with the presence of carotid plaque and whether its presence is associated with the presence and extent of coronary artery disease. A MEDLINE search subsequently was performed to determine whether carotid plaque burden predicts future CV events.

Ultrasound-detected carotid plaque as a screening tool for advanced subclinical atherosclerosis.

Background: There is great need for a simple, noninvasive tool that can be used in an office setting to screen for subclinical atherosclerosis. In patients referred for cardiovascular (CV) risk assessment, we evaluated the ability of ultrasound screening for carotid plaque to identify patients with advanced subclinical atherosclerosis.

Methods: Consecutive asymptomatic patients without vascular disease referred by their physician for measurement of the ankle-brachial pressure index and carotid intima-media thickness (CIMT) were included.