The two articles in the area of cardiovascular physiology and disease in youth were chosen for commentary because of their exploration of new approaches to the diagnosis and management of cardiovascular derangements in young persons. The first, by Hinds et al., describes the potential clinical importance of detection of cardiovascular changes during exercise testing in adolescent athletes following concussions. This approach might prove useful in establishing safe return-to-play guidelines. The second, a review article by Van De Schoor et al, evaluates the frequency of myocardial scarring in athletes, some of adolescent age, which is a recognized risk factor for sudden cardiac death. These findings support other evidence indicating that sports participation per se might rarely increase the risk of such tragedies. Clearly more research is indicated by the information raised in both of these articles, but their importance to clinical medicine is obvious.
The author is with the Dept. of Pediatrics, Baystate Medical Centre, Springfield, MA.