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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