Physical examination and ECG screening in relation to echocardiography findings in young healthy adults.
OBJECTIVE
Cardiovascular screening in young adults is an important tool in many occupational settings. Our aim was to test whether screening physical examination and ECG influence the rate of abnormal echocardiogarphic findings in young healthy subjects.


METHODS
Consecutive echocardiography results of 18- to 20-year-old flight candidates were analyzed retrospectively. Echocardiographies were performed as part of a screening protocol, which includes ECG, physical examination and referral for echocardiography for any positive finding. A second stage includes universal echocardiography for all candidates.


RESULTS
1,066 subjects were evaluated; 489 subjects underwent echocardiography following referral because of abnormal auscultatory or ECG findings. Findings (mostly mild valvular insufficiencies) were demonstrated in 12.7%, with only 0.6% of subjects disqualified. In subjects who underwent universal echocardiography (n = 577), findings (mostly mild valvular insufficiencies) were detected in 18%, with only 0.5% of subjects disqualified.


CONCLUSIONS
The rate of significant echocardiography findings is extremely low in this young and healthy population. The presence of abnormal findings on either physical examination or ECG screening was not demonstrated to alter the rate of abnormal echocardiographic findings. We suggest that the low yield of screening should be weighed against the cost of an unidentified congenital cardiac lesion in the specific setting.
Landau
Dan-Avi
DA
Aeromedical Center, Israeli Air Force, Tel Hashomer, Israel. dalandau@gmail.com
Grossman
Alon
A
Sherer
Yaniv
Y
Harpaz
David
D
Azaria
Bella
B
Carter
Dan
D
Barenboim
Erez
E
Goldstein
Liav
L
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007557:Israel; D008297:Male; D008889:Military Personnel; D010808:Physical Examination; D012189:Retrospective Studies