Sports Cardiology / Athletic Conditions Flashcards
The cardiac muscle becomes _______ with training
larger
If the heart wall thickness does NOT decrease during de-training this indicates
Possible cardiac disease
Prevalence of sudden cardiac death in young athletes
1 and 3 in 100,000
What is the most common cause of sudden cardiac death
Congenital cardiac disease
What causes Commotio Cordis?
Trauma to the chest wall interrupts the electrical impulse of the heart
Chest blow during repolarization induces
Ventricular fibrillation
What sports have been associated with greatest number of deaths due to commotio cordis?
Sports with hard projectiles (baseball, lacrosse, softball)
What is the major causative factor of commotio cordis?
Timing of the incident
Prevention of commotio cordis
Protective padding
AED/CPR within 3 minutes
What is Hypertrophic Cardiomyopathy?
Left ventricle walls thicken
80% of individuals with HCM have __________
Abnormally small coronary arteries causing myocardial ischemia
Both ______ wall distensibility and incomplete myocardial relaxation contribute to _________ left ventricular filling
Decreased, altered
Symptoms of hypertrophic cardiomyopathy
Fatigue
Dyspnea
Exertional angina
syncope- temp loss of consciousness
Exertional angina, syncope and near syncope are all
Conditions that could cause sudden cardiac death and warrant immediate referral
What could be heard when listening to a heart with hypertrophic cardiomyopathy?
Harsh precordial ejection murmur at the left lower sternal border
MRI of someone with Hypertrophic Cardiomyopathy will show _____
> 15 mm ventricular wall thickness
An echocardiography will show what with hypertrophic cardiomyopathy?
Ventricular septum or free wall thickness
Decreased ventricular diastolic activity (<45mm)
Discontinuing activities for __________ may help to determine HCM
A few weeks to 1 month
Classification of Sports based on peak static and dynamic components
Picture
Can individuals with HCM that have a implantable cardioverter defibrillator participate in competitive sports?
NO
Athletes with hypertrophic cardiomyopathy should be restricted from ____ competitive sports with possible exception of ________
ALL
Low-intensity sports (class 1A)
Prevention of death from hypertrophic cardiomyopathy
Comprehensive medical history
Screening
What is the second leading cause of sudden death in athletes?
Coronary artery abnormalities
When do most events happen with coronary artery abnormalities?
During or just after strenuous exercise
How are coronary artery abnormalities characterized?
Aberrant (deviating or abnormal) coronary artery
Complete absence of coronary artery
Coronary artery abnormalities are usually involve which artery?
Left anterior descending artery
Signs and symptoms of coronary artery abnormalities
Angina with exertion
Exertional syncope
Near syncope with exertion
Exertional dyspnea
A heritable disorder of the connective tissue
Marfan syndrome
Physical features of Marfan syndrome
Arm-span to height ratio >1.05
Steinberg sign
Walker-murdoch sign
Cardiovascular features of Marfan Syndrome
Enlarged aorta
Aortic regurgitation due to rupture of aorta
What is Myocarditis
Inflammatory acute or chronic disease of the myocytes
What happens to the ventricles with Myocarditis
Become stretched out
Signs and symptoms of Myocarditis
CHF-like
pitting edema
palpitations
tachycardia
S3 heart sounds
Treatments for myocarditis
Diuretics
Antiarryhythmia drugs
Decrease sodium and caffeine
How long must a person diagnosed with myocarditis stop their sport
AT LEAST 6 months
What is Congenital Aortic Stenosis
Impaired left ventricle outflow with hypertrophy of the intraventricular septum and left ventricular wall
Signs and symptoms of Congenital Aortic Stenosis
Ischemia
Hypotension
Exertional syncope
Heart murmur
What shows up on an EKG with Congenital Aortic Stenosis?
In V5 R >35mm
ST depression
T wave inversion in V6
Can those with severe congenital aortic stenosis participate in competitive sports?
NO
What happens with Mitral Valve Prolapse
blood leaks back into the left atrium at systole
Symptoms of Mitral Valve Prolapse
Heat palpitations
SOB
Can those who are asymptomatic with Mitral Valve prolapse participate in sports?
Yes
What is heard with Mitral Valve Prolapse when performing heart sound auscultations?
Mild to late apical click and systolic murmur
What movements increase sound of the murmur in those with Mitral Valve Prolapse?
Valsalva maneuver
What is Wolff-Parkinson-White sydrome?
Ventricular pre-excitation and tachycardia
What signs on an EKG indicate Wolff-Parkinson-White syndrome?
Short PR interval (<0.12s)
Prolonged QRS (>0.12s)
Signs and symptoms of Wolff-Parkinson-White sydrome?
Periods of unconsciousness
Treatment for Wolf-Parkinson-White syndrome
Surgery if symptomatic
Catheter ablation
If an individual with Wolff-Parkinson-White syndrome is over 20 years old without structural disease and ASYMPTOMATIC can they participate in all sports?
YES
What type of sports can those individuals with Wolff-Parkinson-White syndrome <20 yrs old and ASYMPTOMATIC participate in?
moderate to high intensity
Symptomatic individuals with Wolff-Parkinson-White syndrome can have a HR of _________
> 240 bpm
When is there no limitation on activity for those with arrhythmic conditions?
ASYMPTOMATIC
NO STRUCTURAL HEART DISEASE
What is anemia?
Decrease in RBC
Signs and symptoms of anemia
Fatigue
Decreased performance
Orthostatic hypertension
Pallor
Craving ice
What is the normal range for complete blood cell count?
4.2-6.1
What level indicates iron deficiency?
<12 ng/ml
What is the normal iron level for women?
12-263 ng/ml
What is the normal iron level for men?
20-250 ng/ml
What does a decrease in B12 and folate mean?
Malnourished athlete
If serum iron levels decrease, what does it indicate?
Chronic disease anemia
What foods are high in iron and should be consumed by athletes with anemia?
organ meat
lean red meat
dark poultry
shellfish
eggs
legumes
iron-fortified cereal
What is exertional hemolysis?
Intravascular breakdown of RBC
What type of athlete is external hemolysis most common?
Runners
What does exertional hemolysis cause?
Decrease in iron stores/anemia
Signs and symptoms of exertional hemolysis
Dark urine
What is sickle cell anemia?
Genetic deficit in hemoglobin
What does sickle cell anemia cause?
Chronic hemolytic anemia b/c abnormal shape of the RBC
Ischemia in distal areas due to “log-jam” of the RBC in vasculature
What can an individual with sickle cell anemia still do when they collapse?
Articulate
Symptoms of sickle cell anemia
Sudden onset
hypotension
tachycardia
cramps
hyperventilation
What is the difference between sickle cell anemia and sickle cell trait?
Sickle cell anemia you have abnormal genes from BOTH parents
Sickle cell trait abnormal genes from ONE parent
Can individuals with sickle cell anemia participate in sports?
Rarely, maybe class 1A
Can individuals with sickle cell trait participate in sports?
Yes