Cardiovascular Screening of High School Athletes

To the Editor: Drs Glover and Maron¹ address the issue of improving the sensitivity of the preparticipation cardiovascular screening process for high school athletes. In this context, cardiac troponins may be useful in the identification of athletes with minor degrees of myocardial injury² who are at high risk of progressing to more extensive damage and developing serious complications. Troponins also can be used to evaluate athletes with chest pain and other symptoms that are more subtle, such as nausea, abdominal pain, or fatigue, whose risk of serious adverse cardiac events is low. The use of troponin proteins in the diagnosis of myocarditis has been described recently.³ The technology exists for rapid measurement of cardiac troponin T (cTnT) and cardiac troponin I (cTnI). Point-of-care testing, both qualitative and quantitative, for cTnT and cTnI is already available.⁴ A currently available cTnT immunoassay in strip format requires no specialized laboratory equipment, is easily performed by medical personnel, can be performed in the gym or stadium, uses whole blood, and is completed within 20 minutes.⁵ The automated evaluation of this test with a compact bench-top instrument combines rapid diagnosis with quantitative results.⁵ In addition, an automated evaluation ensures standardized results, as it eliminates potential sources of error by visual reading.⁵ More important, we have shown that capillary blood can be used as sample material for the detection of cTnT.⁵ Troponin measurement may permit more frequent detection of cardiovascular lesions associated with morbidity in young competitive athletes.