Abstract
Potential risk of sudden death during sports participation makes screening of competitive athletes of vital importance. Congenital cardiac anomalies and non-atherosclerotic, acquired myocardial conditions are primary causes underlying exercise-induced cardiac death in young patients. Since cardiovascular conditions are the leading causes of non-traumatic, exercise-induced cardiac events, cardiovascular screening preceding sports participation in mandatory. The objectives of this study were to determine prevalence of cardiac conditions through cardiovascular screening of young athletes and to establish preventive strategy. The study was conducted at the Sports Medicine Center of Sarajevo Canton and at the Pediatric Clinic of University of Sarajevo Clinics Centre in the period 2007-2009. The study was supported by Canton Sarajevo Ministry of Health and Ministry of sports, science and culture. The study targeted a group of 214 athletes, 8-18 years of age with average age being 15.26. The group was subdivided into five groups according to the age. After taking the anamnesis (family, personal and cardiological) patients were subjected to the measuring of body mass and height, blood pressure and heart rate and oxygen saturation, recording of 12-lead ECG, specialist examination (pediatrician, sports medicine specialist and cardiologist) and complete heart echocardiography. No examined athletes expressed subjective discomfort. Congenital cardiac anomalies were not diagnosed in any athlete. Also, cardiovascular abnormalities requiring additional evaluation, positive cardiac anamnesis, abnormal auscultatory findings, hypertension or abnormal ECG findings were not recognized in any patient. Moderate correlation was found among the left ventricle mass and heart rate (p<0.05). In order to minimalize or even possibly prevent the risk of sudden cardiac death it is necessary to establish an adequate strategy of cardiovascular screening of young athletes.
Highlights
In younger athletes, atherosclerotic conditions are rare causes of exercise-induced cardiac events. e occurrence of myocardial infarction in this age group ought to initiate investigation into non-atherosclerotic causes such as: coronary anomalies, vasculitis, drug abuse or hereditary anomalies of lipid metabolism ( ). e prevention of exercise-induced cardiac events is complicated because those events are rare
MHz probes, with standard sections using M mod, B mod, CW Color Doppler technique. e analyzed parameters are presented in millimeters per body mass (BM) in kilograms: LV end-diastolic diameter (EDD LV), LV end-systolic diameter (ESD LV), intraventricular septum diameter (S), LV posterior wall (LVPW), LV reduction fraction (RF) with supramitral flow (SMF)
Echocardiographic measurements Echocardiographic data analyzed for all the subject groups are presented in Table . e data include mean values and standard deviations for the following parameters: left ventricular diastolic diameter (LVDD), left ventricular systolic diameter (LVSD), interventricular septum diastolic thickness (IVSd), LV posterior wall diastolic thickness (LVPWd), left ventricular mass (LV Mass) and left ventricular index mass (LV Index Mass)
Summary
Atherosclerotic conditions are rare causes of exercise-induced cardiac events. e occurrence of myocardial infarction in this age group ought to initiate investigation into non-atherosclerotic causes such as: coronary anomalies, vasculitis, drug abuse (including cocaine and possible anabolic steroids) or hereditary anomalies of lipid metabolism ( ). e prevention of exercise-induced cardiac events is complicated because those events are rare. Atherosclerotic conditions are rare causes of exercise-induced cardiac events. E prevention of exercise-induced cardiac events is complicated because those events are rare It heavily depends on the selective screening of the participants and detailed evaluation of symptomatic athletes prior to the authorization of their participation in sports ( ). The athletes must meet certain physical requirements determined by the type of sports Such systematic evaluation cannot identify children and adolescents with no apparent difficulties but who may have underlying congenital cardiac anomalies or myocardial conditions. E objectives of this study were to determine prevalence of cardiac conditions through pediatric clinical, sports-medicine examinations and non-invasive tests that include echocardiography in children and adolescent athletes and to establish prevention and healthcare. Education of parents and sports workers on the prevention of coronary diseases is conducted simultaneously
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