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cardiology

Category
During our Annual meeting of the Society for Pediatric Sports Medicine in Basel 2017 one of the highlight sessions was the PRO-CON discussion about the use of a resting ECG as screening tool to detect youth at risk for sudden cardiac death. We present the two statements of the cardiology ­experts that were finally not so controversial as the PRO-CON may suggest. Well as often in medicine, it is the choice of each of you, how to deal with the situation. On one side we are taught to know and listen to the “evidence in medicine”, but on the other side we so often end up in our traditional professional perspective as decision maker that is not always wrong …
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Over the last years, cardiac rehabilitation services have expanded their indication to include not just patients after myocardial infarction or surgery, but also a variety of non-acute cardiovascular disease (CVD) states like stable coronary artery disease, peripheral artery disease, neurovascular disease as well as asymptomatic patients with no history of CVD but with a constellation of cardiovascular risk factors, especially metabolic syndrome and diabetes mellitus. In 2015, 110 ambulatory cardiovascular prevention and rehabilitation programs existed in Switzerland: 57 for cardiac, 17 for peripheral artery disease and 36 for diabetes rehabilitation.
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Physical activity (PA) and exercise training (ET) are central and indispensable components for primary and secondary prevention of cardiovascular disease (CVD). In healthy individuals, PA reduces all-cause and CV mortality and has confirmed beneficial effects on the cardiovascular risk profile. In secondary prevention, PA counselling und ET are two of the core components of a multidisciplinary cardiac rehabilitation (CR) program. Exercise-based CR is an established strategy in the secondary prevention of CV disease. It improves survival, reduces hospital admissions, improves cardiorespiratory fitness (CRF), and quality of life (QoL).
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Regular physical activity (PA) is a cornerstone of good health in the ageing population. Cardiorespiratory fitness is an important surrogate marker for survival. In primary cardiovascular disease prevention, PA is considered an effective mono­therapy with beneficial effects on the cardiovascular risk profile (e.g. lipid profile, blood pressure, diabetes mellitus, body composition) and endothelial function. In secondary prevention, PA is an addition to, rather than a replacement for evidence-based medication.
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