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?
- Has the child ever experienced:
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
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.
