Athlete's Heart Flashcards
What are some normal physical exam findings in the cardiopulmonary system of an athlete?
- reversible left ventricular hypertrophy
- bradycardia
- increased VO2 Max
- Sinus arrhythmia
- Transient Split S2
Which syncope event is more concerning for athletes, during exercise or post exercise?
During exercise
What are the screening recommendations for syncope in athletes?
- until diagnosis or pathologic causes excluded, exercise is generally restricted
- R/O post vs. during; ask bystanders
- Screen for defects (MArfan’s, HCOM etc.)
When does dehydration most commonly cause arrythmias?
When coupled with heat illnesses it can potentially trigger arrythmias
What acute changes happen to the right ventricle after exercise?
What are the chronic changes to the RV post exercise?
-elevation of proBNP and increased cardiac troponin T levels which is reversed in the days after exercise
- accumulation of coronary artery calcium (CAC) with myocardial fibrosis
- RV fibrosis secondary to episodic volume/pressure overload
- Increased prevalence of atrial fibrillations
What is the leading cause of non traumatic mortality in athletes?
What is the most common mechanism?
Which populations are most at risk?
Sudden Cardiac Death
ventricular tachyarrythmia (exception Marfan syndrome usually aortic dissection/rupture)
black african american males (however athletes are not at a greater risk for SCD than the general population)
How does the ejection murmur from HCOM (hypertrophic cardiomyopathy) change with position?
softens during sitting/squatting and amplifies during standing/valsalva
True or False: HCOM usually lessens when an athlete becomes detrained.
False, hypertrophic cardiomyopathy is persistent despite detraining
What is the most common coronary anomaly for Athletes?
left coronary artery origins in the right sinus of Valsalva and right coronary artery origins in the left sinus of Valsalva
How common are cardiovascular disorders in patients w/ Marfan’s Syndrome?
What are the interventions for Marfan’s Syndrome?
9/10 pts. with Marfan’s have a CVD such as an aortic tear/rupture, mitral valve prolapse, aortic regurgitation, or arrythmias
- close monitoring
- medications for arrythmias
- surgery to correct defects
- activity modifications
What is Commotio Cordis?
How can it be prevented?
when a sudden blunt impact to the chest causes sudden death in the absence of cardiac damage
- having defibrillators present at events
- shields not demonstrated to be effective
- educate coaches and players to turn away chest from inside pitches
What are the normal ECG findings in athletes?
- sinus bradycardia
- sinus arrythmia
- ectopic atrial rhythm
- incomplete RBBB
- isolated QRS voltage criteria for LVH
- early repolarisation
What is the most common cause of SCD in pts under 35 years old?
Hyptertrophic Cardiomyopathy
