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Hypertrophic cardiomyopathy screening
(詳細はsudden cardiac death (SCD) in young athletes. HCM is frequently asymptomatic until SCD, and thus its prevention requires screening. Screening by medical history and physical exam are ineffective, indicating heart abnormalities in only 3% of patients who subsequently suffered SCD. However, HCM can be detected with 80%+ accuracy by echocardiograms, which may be combined with pre-screening by electrocardiograms (ECGs). Routine cardiac screening of athletes has been implemented in Italy since the 1970s, and has resulted in an 89% drop in cases of SCD among screened athletes. In the United States, the American Heart Association has "consistently opposed" such routine screening. (See for a popular summary of literature and discussion). However certain chapters of the American College of Cardiology are backing screening models provided by private entities and nonprofit organizations.
== Description ==
HCM is a genetic disorder that causes the muscle of the heart (the myocardium) to thicken (or hypertrophy) without any apparent reason. When the heart thickens and becomes enlarged, particularly at the septum and left ventricle, it can cause dangerous arrhythmias (abnormal heart rhythms). The thickening of the heart makes it harder for blood to leave, forcing the heart to work more vigorously to pump blood.
HCM occurs in up to two per 1000 people in the general population, being a primary and familial malformation. While younger individuals are likely to have a more severe form of hypertrophic cardiomyopathy, the condition is seen in people of all ages. Studies have shown that HCM is generally regarded as the most common cause of sudden cardiac death in athletes, accounting for 36% of deaths. Almost half of deaths in HCM happen during or just after the patient has done some type of physical activity. Sudden death is frequently the first indication of the presence of HCM, where 90% of deaths in athletes occur in males. This is potentially due to the higher frequency of participation at a higher intensity in male athletics. 60% of athletes are of high school age at the time of death.
The first symptom of HCM among very young patients tends to be sudden collapse and possible death. However, other symptoms include exertional dyspnea (most common), chest pain, dizziness, fainting, high blood pressure (hypertension), heart palpitations, fatigue and shortness of breath. However, some patients have no symptoms and may not realize they have the condition until it is found during a routine medical exam.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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