Table 1.

Diagnostic, probable high-risk criteria at MRI-based screening for elite athletes or military recruits.

Screening method	Criteria of probable high-risk conditions at primary screening stage
History	•History of syncope, sudden cardiac arrest, or aborted SCD (especially with associated angina pain) •Family history of SCD at age <35 years •In patients with potential hr-CVCs at screening MRI: exercise-limiting angina, dyspnea, dizziness
Physical exam	•Hypertension in upper extremities, with small pulses in lower extremities, and MRI evidence of coarctation of aorta •Systolic precordial murmur, increasing with Valsalva maneuver, and MRI evidence of HCM
ECG	•As per international criteria [19]
Cardiac MRI	•HCM, by criterium 1a = IVS thicker than 1–2 SD above the normal average value for the patient’s group (see Angelini et al. [3], where one can find normality MRI tables for age, BMI, sex, race) •HCM criterium 1b = LV mass index greater than 1 SD from group’s MRI average (see Angelini et al. [3] for normality ranges) •Coarctation of aorta, ascending aorta aneurysm (Marfan-like?), with severity by measurements •DCM, by criterium 2a = LVEDD greater than 1 SD from average (see Angelini et al. [3] normality tables); criterium 2b = LVEF < 40% •Patients with positive Petersen anatomical criteria (MRI) for NCLV, with LVEF < 40%, and symptomatic for effort-related dyspnea (criterium 2c) •Coronary anomalies: ACAOS-IM of a main coronary artery, with ectopic origin and probable intramural course by criteria: (a) ectopic artery passing in front of the aorta, at the anterior aortic commissure, while (b) coursing to the proper sinus of Valsalva, about the sinotubular junction level on the vertical axis; (c) a more than 2:1 luminal ratio of long to short diameters in a cross-sectional proximal section

ACAOS-IM, anomalous origin of coronary artery from the opposite sinus of Valsalva with intramural course; BMI, body mass index; DCM, dilated cardiomyopathy; HCM, hypertrophic cardiomyopathy; hr-CVC, high-risk cardiovascular condition; IVS, interventricular septum; LV, left ventricle; LVEDD, left ventricular end diastolic diameter; LVEF, left ventricular ejection fraction; MRI, screening magnetic resonance imaging; NCLV, noncompaction left ventricle; SCD, sudden cardiac death.