Performing physical exercise produces a functional and mechanical overload on the heart, something that can endanger the life of the athlete if there are heart diseases that have gone unnoticed in routine examinations. Dr. Rodriguez Rodrigo, an expert in Cardiology, talks about these diseases that occur asymptomatically and can lead to serious complications in the lives of athletes.
Importance of performing cardiological examinations
Few athletes suffer sudden death, but when this happens there is great alarm in their environment because they are apparently healthy people. The problem is that many people engage in numerous sports activities without being aware of their real cardiovascular fitness, which poses a risk.
There are three groups of people with respect to cardiovascular sports risk:
- Those who engage in sport on a regular basis, with high levels of training and who have ever undergone medical examination tests.
- Those who give up sport for a while and want to resume it.
- Those who want to start the activity without ever having exercised regularly before.
All of them can benefit from regular medical check-ups to check their cardiac function, but the last two are those who absolutely need this prior cardiological check-up to prevent any type of anomaly or complication. Among adults under 40 years of age, the leading cause of sudden cardiac death is related to congenital heart anomalies and, at this age, to obstructive coronary artery disease.
What a good cardiological examination should include
A good cardiological examination should include:
- Complete clinical history of the patient, with personal history, family history, lifestyle habits and physical examination focusing on the cardiovascular aspect.
- Electrocardiogram to rule out electrical abnormalities of the heart and indirect data of underlying heart disease.
- Echocardiogram to study the anatomy and function of the heart and large blood vessels.
- Ergometry or stress test performing a progressive level of effort in terms of gait and percentage of slope on a treadmill.
From these tests, symptoms and pathological exploratory data should be collected with effort, final functional capacity (in METS units), heart rate, blood pressure and continuous electrocardiographic recording. All this is done in order to rule out ischemic type alterations as well as heart rhythm and electrical conduction disorders induced by physical activity that can cause sudden death. This can be combined with an oxygen consumption test to calculate the aerobic threshold in trained athletes.
If the result of these tests is normal, sporting activity can be safely initiated or maintained. In case of any suspicion of specific cardiac pathologies, the specialist may require additional complex tests such as genetic testing, coronary CT angiography, cardiac MRI or even coronary arteriography.