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Commentary 2 on "Bicuspid aortic valve in competitive athletes"
Australian Institute of Sport, Canberra, Australia; Kieran.Fallon@ausport.gov.au
Bicuspid aortic valve in competitive athletes
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This paper adds fire to the controversy about the extent of pre-participation cardiac screening which was recently somewhat quelled by the publication of the 2007 guidelines from the American Heart Association (Circulation 2007;115:1643–55). This paper holds arguments both for and against screening by echocardiography. If there is little evidence for negative outcomes from the presence of a bicuspid aortic valve specifically related to participation in exercise, no evidence of a higher incidence in athletes when compared with the "normal" population and no general recommendation for echographic screening for everyone, where is the evidence for this screening in athletes? On the other hand, the authors have identified a large number of other defects such as mitral valve prolapse, patent foramen ovale and ventricular and atrial septal defects in their subjects. This adds weight to their conclusions.
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