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


STRATEGY OF CARDIOVASCULAR TESTING IN YOUNG ATHLETES FOR THE PREVENTION OF CARDIAC COMPLICATIONS

Alexander Kisko¹, Jan Kmec¹, Anna Eliasova¹, Lubica Dernarova¹, Zdenka Uherova¹, Anna Hornakova¹, Andriy Shyp², Olesja Horlenko², Nelli Kishko N², Vasylyna Svystak²
¹ Cardiology Clinic, J.A.Reiman University Hospital, Faculty of Health Care, Presov University in Presov, Slovak Republic
² Centre for Sports Medicine, Medical Faculty, Uzhgorod National University, Uzhgorod, Ukraine

Cardiovascular screening in young athletes has traditionally been performed by means of personal or family history, physical examination with or without 12-lead ECG. This screening protocol has a limited power to detect potentially lethal cardiovascular abnormalities in young athletes The future for prevention of sports-related cardiovascular complications and fatalities lies in continuing efforts to better understand the substrates and mechanisms underlying sudden cardiac death in the athletes and to design more specific and efficient testing strategies.
The aim of the pilot stage of the international Slovak-Ukrainian project is to elaborate a protocol of cardiovascular examination for young competitive athletes for further testing of it in sports cardiology practice for reduction of the incidences of cardiovascular complications and fatalities.
The proposed cardiovascular protocol includes family and personal history, physical examination, intensity of training load, blood pressure measurements, as well as mandatory basal 12-lead ECG, that is considered positive, according to accepted criteria. Subjects who have positive findings at basal evaluation are referred for additional testing, such as EchoKG, Holter ECG, HRV, ABPM, exercise or pharmacological testing, SAECG, TEAS, or in uncertain cases stress myocardial perfusion imaging, cardio CT or MR imaging, coronary angiography, and electrophysiological study may be necessary in order to confirm or rule out the suspicion of heart disease or abnormalities.
Although the implementation of the testing protocol in both countries depends on the particular socio-economic and cultural backgrounds as well as on the specific medical systems in place, the hope is that the proposed strategy of cardiovascular testing in young athletes may have a significant practical and ethic value as well as socio-economic impact.
Key words: sports-related complications, cardiovascular testing, protocol.





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