Cardiac Auscultation in Sports Medicine: Strategies to Improve Clinical Care

Cardiac auscultation is an important part of the preparticipation physical examination of athletes. Sudden death remains a rare but tragic event among athletes. The most common cause of sudden death among young athletes in the United States continues to be hypertrophic cardiomyopathy, which may or may not present with a typical heart murmur. Many clinicians do not possess sufficient proficiency in recognizing abnormal heart murmurs. New insights in the field of auditory learning suggest that cardiac auscultation is more of a technical skill than an intellectual one. Intensive repetition of abnormal heart murmurs has been shown to improve proficiency in cardiac auscultation markedly. Sample audio files of two important murmurs, i.e., an innocent murmur and hypertrophic cardiomyopathy, are provided online with this review

Giant Saphenous Vein Graft Pseudoaneurysm: Treatment with a Vascular Occlusion Device

We report the case of a 74-year old male who was evaluated for progressively enlarging right heart border on serial chest radiographs. Computed tomography of the chest revealed a pseudoaneurysm arising from the saphenous vein graft (SVG) to the posterior descending artery with mass effect on the right atrium. Coronary angiography showed severely compromised distal flow and an angiographically small territory at risk. Using a minimally invasive, catheter-based approach, an Amplatzer Vascular Plug II occlusion device was utilized successfully for embolizing the SVG pseudoaneurysm