Editorial 2-2019

Der Begriff «Sportkardiologie» ist manchmal umstritten und wirft Fragen auf. Ist es wirklich notwendig, medizinische Subspezialitäten, zumindest semantisch, mit der Sportmedizin zu vermischen? Das ist es, meiner Meinung nach, absolut.…

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Fundamental motor skills in 4 to 6 year olds in Switzerland – a comparison between traditional and «physical activity» kindergarden

Until now, there have been no studies in Switzerland that investigate differences in the motor performance disposition of children in urban and rural as well as in traditional and physical education kindergartens. A newly developed test instrument (MOBAK-KG) was therefore used in a supra-­cantonal research project in school year 2017/18 to test the motor skills of 4- to 6-year-old children (n = 403, Ø 5,7 years, SD = .56) in the areas of “self-movement” and «object-movement».

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Exercise Hypertension – A Review

The actual significance and definition of hypertensive response to exercise (HRE) is still debated. Up to now, there is consensus in defining it as a systolic blood pressure value of either ≥ 210 mmHg in men and ≥ 190 mmHg in women or a diastolic blood pressure ≥ 110 mmHg during maximal exercise stress test. The mechanisms underlying an exaggerated blood pressure response to exercise are poorly understood; however, there are studies suggesting that HRE may represent a preclinical stadium of essential hypertension, which shares several common pathological mechanisms mostly related to an endothelial dysfunction and vascular stiffness.

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Cardiopulmonary Exercise Testing in Athletes; a case-based review

Cardiopulmonary exercise testing (CPET) is recommended in pre-participation evaluation of athletes to measure their cardiorespiratory fitness and maximal exercise tolerance. It is used for the diagnosis of probable cardiovascular and pulmonary disease and for the investigation of possible risks in sports. In case of non-specific symptoms during exercise, which are frequent in athletes, CPET is useful in the evaluation of physiological responses of body organ systems to exercise. This case-based review demonstrate the potential of CPET in the assessment of fatigue and loss of performance in a competitive professional athlete.

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Diagnosing and sports counselling of athletes with myocarditis

Myocarditis is defined as an inflammation of the heart muscle and its presentation, especially in athletes, is heterogeneous. Underlying causes include in most of the cases viruses, and less often bacteria, toxins, vasculitic diseases or pharmaceutical agents. Cardiac magnetic resonance (CMR) imaging is the primary imaging tool to diagnose myocarditis following laboratory test, electrocardiogram and echocardiography. In certain cases, endomyocardial biopsy is required, especially in unclear cases with reduced systolic left ventricular ejection fraction.

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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).

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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.

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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.

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The effects of long-term vigorous endurance exercise on the coronary arteries

Moderate endurance training is known to improve cardiovascular risk factors, and prolongs life expectancy. On the other hand, there has been some discussion whether “too much” exercise might have a contrarious effect by accelerating coronary atherosclerosis. The goal of this review was to evaluate the current literature on the effects of long-term vigorous endurance training on the coronary vasculature. In summary, data point to an increased calcium score, and a higher burden of atherosclerotic plaque in male athletes compared to sedentary controls.

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