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"Medicina Sportiva" No.14 - 2008 The 15-th Sports Medicine Balkan Congress
SPORTS CARDIOLOGY


GRAY ZONE PROBLEM IN ATHLETES

Kasikcioglu Erdem
Istanbul University, Faculty of Medicine, Department of Sports Medicine, Turkey

Sports physicians are frequently involved in an effort to increase the participation of competitive sports, and decrease any potential risk among subjects with heart disease. Healthy young athletes very rarely experience extremely severe cardiovascular events, these events are dropped a bomb into population. Hypertrophic cardiomyopathy is a complex cardiac disease with a heterogeneous genetic, morphologic, and clinical spectrum and it is the most important cause of sudden cardiac death among young athletes. The diagnostic criteria for hypertrophic cardiomyopathy includes a hypertrophic, but not dilated, left ventricle, in the absence of systemic disease or left ventricular hypertrophy due to left-sided obstruction. The differentiation between physiological and pathologic hypertrophy may be difficult, and is important in determining the presence or absence of cardiac disease in athletes in order to prevent exercise- related sudden cardiac death.
A specific finding in this study is a lower incidence of grey scale in athletes, even though high prevalence of hypertrophic cardiomyopathy is thought to be expected in the general population.  It is accurately known frequency known highly trained adult athletes show mildly increased left ventricular wall thicknesses of hypertrophic cardiomyopathy diagnostic level, which define a grey zone where extreme expressions of athlete’s heart and mild morphological forms of hypertrophic cardiomyopathy overlap. Although echocardiography may not be cost-effective, it is a valuable non-invasive method for differentiating cardiac pathologies other than athlete’s heart. Echocardiography is not only helpful for the accurate diagnosis of hypertrophic cardiomyopathy, but also facilitates its risk stratification, such as the level of outflow tract obstruction.





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