Le bilan cardiovasculaire du sportif de haut niveau

Abstract

AbstractHealth benefits of regular moderate physical activity or sport are well proven. However, the vigorous sport practice can induce acute cardiovascular events that reveal an unrecognized heart disease.In order to prevent the occurrence of these dramatic cardiovascular events, a preparticipation cardiovascular evaluation for vigorous sport has been proposed. The content of this evaluation carried out by the general practitioner currently recommended associates an history, a physical examination, and a resting-electrocardiogram. The electrocardiogram analysis must take into account the electrical specificities associated with intensive physical training. The education of the athlete concerning intense sports practice should be associated. Other cardiovascular exams which may be associated with it must always be targeted and never systematic. Analysis of these exams, mainly imaging one, must take into account the athlete’s heart patterns specificities. Although this evaluation is able to detect arrhythmogenic cardiovascular diseases, it has not been formally demonstrated that it could prevent the occurrence of serious cardiovascular events. Thus, its content deserves to be improved by favoring non-invasive explorations and with an acceptable cost/effectiveness ratio, for a better identification of athletes with cardiovascular risk and a more precise stratification of their individual risk to avoid abusive sports disqualifications.