The significance of heart murmurs in school athletes.

The high incidence of heart murmurs in young people contrasts with the relatively small number having heart disease. However, sudden death due to heart disease does occur in athletes. The physician interested in sports has a two-fold responsibility. He is obligated to protect the athlete from major harm, and at the same time must guard against over-caution leading to iatrogenic heart disease.Each prospective candidate for organized sporting events should be assessed with a detailed history, physical examination, electrocardiogram and chest x-ray. If cardiac disease is suspected then hemodynamic catheterization studies become necessary to establish a definite diagnosis as well as to assess the functional capacity of the heart.