preparticipation – Seite 2

sports medicine cardiology team management preparticipation

Regional differences of sudden cardiac death in sports. Experiences from German and Swiss registries

Sudden death of an athlete is the most devastating medical event in sports. While accidents account for more than 50% of these cases, sudden cardiac deaths (SCD) are less frequent (approx. 15%), but the leading medical cause of deaths. The risk depends on age, sex, ethnicity, type of sport and sport level. There are large variations in the methods of registration of SCD in recreational and competitive sports. This must be taken into account when interpreting reported incidences and causes. High data quality in registries is a prerequisite for meaningful preventive strategies (e.g. ECG screening and safety at sports facilities).

sports medicine cardiology team management preparticipation

The International (Seattle) Criteria

Through continuous improvement of diagnostic accuracy of ECG criteria for athletes sensitivity as well as specificity have grown so much that foregoing this screening tool is not feasible anymore. The most updated guidelines, the so-called “International (Seattle) Criteria” globally exhibit the most important reference publication, currently. The criteria were created with the purpose that particularly “non-cardiologists” should be able to use them before clearly pathological findings lead to further follow-up examinations at a specialist. On the other hand, physiologic ECG findings should not prompt expensive further evaluations, as it used to happen quite frequently.

sports medicine cardiology team management preparticipation

Recommendations for cardiovascular evaluation in athletes – a viewpoint

Traditionally, cardiovascular screening has been recommended mostly for competitive athletes younger than 35 years. The perception that only young competitive athletes at top level are at increased risk, has changed in the last years. Theoretically, we advocate a voluntary cardiovascular screening for all athletes who exercise vigorously, independent of their competitive status, and age. Although, this should be based on an individual estimation of the athlete’s risk. Physical examination, medical history and an ECG should be the baseline investigations for all athletes.

exercise physiology sports and youth preparticipation sports medicine cardiology performance

Cardiopulmonary exercise testing in children and adolescents

In cardiopulmonary exercise testing with children and adolescents, age specific protocols are used together with tools adjustable to their body dimension and development. Assessing weight, height und pubertal stage is a prerequisite for the interpretation of every test. Indications for exercise testing are airway symptoms and findings limited performance, chronic diseases, planning of trainings and scientific studies. The more tests are standardized and used on a large scale, the more normal values are available to compare individual results. However, the interindividual variability of measured values is high, depending as much from the developmental stage of the individual as from protocols, tools and the performing laboratory.

sports and youth preparticipation sports medicine cardiology team management

EKG and sports

There was a longstanding controversy on the role of resting ECG in the preparticipation examination in athletes, as well as in children and adolescent, in leisure time or top athletes. Besides other arguments, this was due to the limited validity, to the false positive and false negative findings often followed by a thorough clinical examination. However, recent studies from different research groups yielded a significant improvement in establishing ECG criteria in athletes discriminating normal from abnormal or pathological findings in athletes.This in addition is supported and improved by a software-based ECG device considering the new Seattle criteria. These new criteria from the Seattle conference reliably discriminate normal from abnormal findings. Frequent ECG findings in athletes, especially in those engaged in endurance sports showed sinus bradycardia, AV-block and signs of left ventricular hypertrophy.

elite sports sports and youth preparticipation sports injury team management

Epidemiology and prevention of injuries in young sportsmen. A 35 year observational study of the sport and art classes in the Canton of Geneva

Injury prevention is a priority in the field of sports medicine and in physical activity promotion, in particular for youth. Injuries can lead to long term handicaps and disengagement from physical activity. The follow up of young sportsmen in the canton of Geneva over the last 35 years has permitted to get an idea of the prevalence of injuries in young sportsmen and allows a comparison with the general population. It has also permitted to get an idea of the influence prevention has had on injuries.

sports and youth growth preparticipation sports medicine preparticipation

Annual preparticipation examination in youth athletes

Ein junger Athlet sollte seine sportliche Tätigkeit über die gesamte Zeit von Wachstum und Entwicklung möglichst erfolgreich und mit Freuden durchführen können. Gerade sind von einem Expertenteam unter dem Hut des IOC lesenswerte Empfehlungen lanciert worden, wie gesunde, belastbare und fähige junge Athleten entstehen und wie diese optimal betreut werden sollen, jeder auf seinem sportlichen Niveau und mit seinen eigenen Erfolgsvorstellungen.