Detailed Medical History Important Part of Sports Physical

While the forms doctors fill out during an athlete's pre-participation physical evaluation or exam (PPE), here's what should be covered during the medical history part of any sports physical:

Heart

• Family medical history. Has anyone in the athlete's family:
  • Died for no apparent reason (SIDS, car accident, drowning)?
  • Had a heart problem?
  • Died of heart problems or sudden cardiac arrest before age 50?
  • Had syncope (fainting) or presyncope (near fainting)?
  • Had unexplained seizures?
  • Had significant arrhythmia (irregular heartbeat) or a pacemaker?
  • Had any of the following genetic disorders:
    • Hypertrophic cardiomyopathy (HCM). Note, however, that one study found that only 25% of athletes with HCM who died of sudden cardiac death had a family history of one or more nontraumatic familial deaths at age 50 or younger.
    • Dilated cardiomyopathy (DCM)
    • Marfan syndrome
    • Ehlers-Danlos syndrome
    • Arrythmogenic right ventricular cardiomyopathy
    • Early coronary artery disease
    • Brugada syndrome
    • Long QT syndrome (LQTS)
    • Short QT syndrome
    • Primary pulmonary hypertension
    • Rheumatic fever
    • Hypertension (high blood pressure) or
    • Kawaski disease?

• Personal Medical History
  • Has the child ever experienced:
    • Chest pain/discomfort with exercise?
    • Excessive, unexpected, or unexplained fatigue with exercise?
    • Excessive, unexpected, or unexplained shortness of breath with exercise? (Note: doctors don't always recognize this as a symptom of congenital heart disease, sometimes mistaking it for exercise-induced asthma. In one case, a 15-year-old boy was pulled out of a soccer game because of shortness of breath and later diagnosed with asthma. A month later, he suffered sudden cardiac death on a soccer field as a result of HCM)
    • Heart palpitations (heart races or skips beats) during exercise?
    • Past detection of a heart murmur or high blood pressure?
    • Unexplained fainting (syncope) or near fainting?

Skin (warts, fungus, blisters, boils or skin infections)

Neurologic (complete concussion history)

• Has the athlete experienced or is he experiencing:
  • Headaches
  • Seizures
  • Post-concussion symptoms
  • History of concussions

Heat illness

Asthma or Seasonal Allergies

• Asthma should be suspected in any athlete with a history of wheezing during sports

Weight concerns (i.e. eating disorders)

Psychosocial Issues

Alcohol, drugs, tobacco, steroids, and/or sexual practice issues

Menstruation

• Primary amenorrhea (absence of periods by age 16) or secondary amenorrhea (absence of period for more than three cycles) may Indicate the presence of the female athlete triad.