Plutselig død hos idrettsutøvere: Svakheter ved screeningundersøkelser
En systematisk legeundersøkelse av friske idrettsutøvere der det jaktes på tidlige tegn til sykdom, kalles screening. En screeningundersøkelse som har som formål å finne personer med risiko for hjertesykdom, er en stor diagnostisk utfordring for legene. I mange tilfeller er det umulig å avdekke slik risiko, i noen tilfeller er funnene så vage at de er lette å overse og hos bare et fåtall er det klare funn på hjertesykdom.
Siden testene legene bruker ved screeningundersøkelsen ikke er 100 prosent treffsikre, og forekomsten av skjult hjertesykdom er liten (mindre enn 1 prosent), vil langt de fleste utøverne som legene finner noe unormalt hos, egentlig være friske. Legene gjør falske positive funn - forandringer som tilsynelatende tyder på underliggende sykdom, men som ved nærmere utredning viser seg å være "falsk alarm". Med andre ord behøver unormale funn ved legeundersøkelsen slett ikke å bety at du er i risikogruppen. Det må avklares gjennom en grundigere undersøkelse.
Fordi hjertefeil er vanskelige å oppdage, anbefales legene å bruke standardiserte spørsmål og standardisert fysisk undersøkelse for å øke sjansen for å finne eventuelle feil.
De europeiske retningslinjene anbefaler at screening starter i 12-14 års alderen og gjentas minst hvert andre år5.
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