Acute Medical Conditions in Athletes - Conditions, Symptoms, Treatment

Introduction:

Children and teenagers with medical disorders have unique challenges when participating in athletic activities. The physician plays a significant role in determining whether the athlete with a health condition should engage in specific sports. It is carried on by evaluating the athlete's health, recommending suitable equipment or sports changes to reduce the risk of injury, and educating the athlete, parents or guardian, and coach of the risks of injury as they are linked to the athlete's condition.

What Are the Acute Medical Conditions that Athletes Encounter?

A. Asthma:

Asthma is a respiratory condition where the airways become inflamed, constricted, and secrete excess mucus. It further leads to breathing difficulty, coughing, and whistling sounds while breathing (wheezing). This is the most common chronic respiratory illness that affects athletes. The most prevalent airway illnesses are asthma, exercise-induced asthma (EIA), and exercise-induced bronchoconstriction (EIB). Asthma has varying degrees of severity and progresses in different ways. It frequently starts in childhood. While some patients only require infrequent or intermittent treatment, others require daily oral or inhalation medications.

Many patients only have asthma symptoms after vigorous exercise. Even though asthma can manifest in many ways, it can be fatal if it is not promptly and effectively treated. Common triggers of these hypersensitivities include allergens, stress or worry, smoke or other environmental contaminants, a cold atmosphere, and even exercise.

1. Exercise-Induced Bronchoconstriction: Exercise-induced airway constriction, or EIB, is a temporary and reversible narrowing of the airways that can develop in people with or without underlying asthma. Exercise causes bronchoconstriction (airway or windpipe narrowing) but not clinical symptoms of asthma.

2. Exercise-Induced Asthma: Asthma that is triggered by exercise.

• Symptoms:

  • Episodic attacks of wheezing and shortness of breath.

  • Chest tightness and a dry cough.

  • The duration of these episodes might range from a few minutes to many hours, or they can linger for several days.

  • Tachypnea (abnormally rapid and shallow breathing) and severe respiratory distress (reduced oxygen supply to the body due to accumulation of fluids in the lungs' air sac) are two symptoms that can accompany severe attacks.

  • In rare circumstances, wheezing can be heard externally without using any equipment.

  • Chronic coughing may be the only symptom in mild instances (cough variant asthma).

  • Elevated respiratory rate.

  • Elevated heart rate.

• Treatment:

  • Long-acting and short-acting inhaled beta-agonist (Salbutamol) medications are the cornerstones of asthma therapy.

  • Leukotriene modifiers, Theophylline, oral and inhaled steroids, mast cell stabilizers like Cromolyn, and others are also used to treat asthma.

  • As the severity of the disease demands, treatment takes a progressive approach in relieving and maintaining stable conditions with medications.

• Impact on Athletes:

  • Several studies have demonstrated that regular exercise and enhancements in physical fitness (particularly pulmonary function) might lessen the symptoms and airway irritability, even though vigorous exercise can cause airway illness.

  • Athletes with mild asthma can typically take part in most sports. Nevertheless, many asthmatic athletes favor sports that entail competing in warm, temperate regions, such as track and field, because chilly ambient temperatures are believed to exacerbate the symptoms of asthma.

  • People with moderate to severe asthma are unlikely to engage in strenuous physical activities because the condition frequently affects performance.

  • Athletes with acute illness exacerbations should stop competing until the acute attack subsides and they are no longer dependent on rescue drugs like Albuterol regularly.

B. Thermoregulation Concerns:

The weather can affect an athlete's performance in different ways. It is important to consider issues about thermoregulation, particularly for athletes who compete in outdoor activities in hot or chilly weather. The body's most efficient method of heat loss is evaporative cooling, which accounts for more than 80 % of heat loss in healthy athletes. Resulting in hypothermia. Spinal cord-injured athletes are especially vulnerable to cold weather. The athlete, athletic trainer (physiotherapist), coaches, and other team members must be aware of not only the weather conditions but also inappropriate warm-up techniques, prolonged periods of inactivity during competition, and dehydration also, play a role.

• Hyperthermia happens when a person's body temperature increases and stays beyond the healthy level of 98.6 °Fahrenheit.

• Heatstroke, the most severe form of hyperthermia, is a life-threatening emergency indicated by a core temperature over 105 °Fahrenheit and a rapid increase in pulse (160 to 180 beats per minute).

• Central nervous system dysfunction is the main sign of heatstroke.

• Symptoms of concussion-like confusion, agitation, improper behavior or language, emotionlessness, wavering emotions, stupor, and, if untreated, coma or death may also result from heat stroke.

• Treatment:

• Hyperthermia:

  • The athlete is relocated to a shaded or cool area, clothing is loosened, equipment is taken off, oral fluids are given, and cooling is achieved with cold water.

  • If the athlete is not conscious, intravenous fluids are given.

  • If heat stroke is suspected, the athlete must first undergo emergency cooling procedures (e.g., cool water application with a sponge, towel body fanning) before being taken to a facility with advanced emergency treatment.

  • Although taking an ice bath has been suggested for athletes in good physical condition, athletes with spinal cord injuries should use caution when using this treatment because their thermoregulatory system is compromised. This is especially true for athletes who have complete, high-level lesions.

  • Cooling might happen too quickly.

• Hypothermia:

  • To treat hypothermia, warm fluids must be given, the athlete must be moved to a warm location, and wet clothing must be removed immediately and replaced with warm, dry gear.

  • It is not recommended to apply heat to paralyzed parts, such as those with heating pads or hot water bottles.

C. Hypertrophic Cardiomyopathy:

It is a heart condition where the heart muscles are thickened, causing difficulty in the heart’s pumping capacity. The main reason for sudden cardiac death in American athletes under the age of 35 is hypertrophic cardiomyopathy (HCM). The inherited illness is characterized by an abnormally hypertrophied but non-dilated left ventricle without triggering physiological conditions like physical training or pathological conditions like aortic stenosis (the narrowing of the valve between the lower-left chamber of the heart and the aorta, the main blood vessel of the heart) or hypertension (increased blood pressure) that would cause left ventricular hypertrophy (wall thickening of the heart's main pumping chamber).

• Symptoms:

  • Fatigue (tiredness).

  • Dyspnea (shortness of breath).

  • Syncope or near syncope (becoming unconscious).

  • Angina on exertion (chest pain while performing exercise).

  • Sudden death.

• Treatment:

  • All competitive sports should be off-limits to athletes with hypertrophic cardiomyopathy, except for low-intensity sports like golfing, bowling, and billiards.

  • Additionally, the recommendations for competitive sports in patients with HCM remain unchanged after installing an implanted cardioverter defibrillator.

  • There is currently no convincing data available to prohibit these patients from participating in competitive sports, particularly in the absence of cardiac symptoms or a family history of sudden death.

  • However, these protocols are followed for the safety of the athletes.

D. Anxiety:

Anxiety is overwhelming, feeling uneasiness, fear, and intense concern about ordinary events. Even though there are considerable cultural variations, anxiety is one of the most widespread human experiences. But depending on several characteristics, including physiology, central nervous system sensitivity, perceptual filters, belief system, coping mechanisms, and social support, people may react to one or more acute or ongoing stresses by developing severe anxiety to be classified as a disease. The person experiences overwhelming concerns, panic episodes, excessive worry, or compulsive behaviors. These anxieties are extremely serious and immobilizing.

• Symptoms:

  • Anger.

  • Irritability.

  • Changes in athletic performance.

  • Illicit drug use.

  • Inability to sleep.

  • Dizziness.

  • Loss of appetite.

  • Fear of losing control.

  • Suicidal tendencies.

• Treatment:

  • Psychological counseling.

  • Depending on the symptoms, a few medications, like serotonin reuptake inhibitors, Benzodiazepines, Venlafaxine, etc., will be recommended to cope with sleep and mood stabilizing.

  • Physical activity.

  • Meditation.

  • Maintaining proper sleep patterns.

  • Avoid alcohol, smoking, or other recreational drugs.

E. Sports Hematuria:

Sports hematuria (blood in urine) is characterized by the benign, self-limiting presence of three or more red blood cells per high-power field in a centrifuged urine test. It is directly related to physical activity or exercise. Asymptomatic sports hematuria has been observed in both contact and non-contact sports. It is thought that the duration and intensity of the activity are connected to the degree of hematuria. In most cases, hematuria in athletes without urinary tract dysfunction will go away within 72 hours.

• Treatment:

  • Resting for 24 to 72 hours is all that needs to be done to treat sports hematuria.

  • Resolution is the norm, and a follow-up urinalysis should be used to confirm this.

  • Sports hematuria is a benign and self-limiting illness. Thus, the prognosis is excellent.

F. Deep Vein Thrombosis:

When a blood clot develops in a large vein, the condition is known as deep vein thrombosis (DVT). As a result, there is a venous occlusion (block in the blood vessel) and distal stagnation towards the clot. These clots typically form in the lower legs. A DVT, however, can develop in any limb. For instance, although uncommon, subclavian vein thrombosis has been documented among baseball players. A DVT develops as a result of numerous factors and typically results from damage to the extremities from an injury or surgery in active people. Prolonged sitting in a bus, car, or plane is an additional contributing factor. A DVT can also be caused by hypercoagulability conditions such as factor V Leiden anticoagulant gene mutation. Additionally, the risk of blood clots is higher for women who use oral contraceptives, especially those who smoke.

• Symptoms:

  • DVT symptoms are frequently nonspecific, and some are asymptomatic (no symptoms).

  • Leg pain and edema are the main signs and symptoms.

  • Standing and walking make these feelings worse in the leg.

  • Upon examination, the affected leg generally has distal edema.

  • This can be verified by comparing it to the adjacent leg.

• Treatment:

  • Anticoagulants (blood thinners).

  • Blood thinners like Heparin or Warfarin should be administered for three months.

  • Athletes under this treatment should not indulge in contact sports.

  • Vitamin K supplements in the desired amount are recommended.

G. Gastrointestinal Issues:

Food poisoning or bacterial diarrhea results in bouts of loose stools when food is not cooked or stored properly. Campylobacter, Staphylococcus species, and Salmonella are the main microorganisms to cause food poisoning. Other bacteria, including Shigella species, Yersinia, Escherichia coli, and Bacillus cereus, also cause infection.

• Symptoms:

  • Dehydration.

  • Stomach cramps.

  • Vomiting.

  • Diarrhea.

  • Fever.

  • Weight loss.

  • Weakness.

• Treatment:

  • Over-the-counter medications used to treat viral gastroenteritis can be used in the initial therapy of diarrhea.

  • A referral is required for a complete evaluation and treatment if the athlete is seriously ill or if there is blood in the stool.

  • Antibiotics may be included.

  • A food worker who has the infection may be the issue and spread it until they receive medical attention.

  • When all symptoms have subsided, the athlete can resume competing once their strength and hydration levels have returned to normal.

Conclusion:

Athletes with acute medical conditions need proper treatment and rehabilitation to return to sports. However, they need to visit the physician when mild symptoms appear to avoid complications. Also, talking with the coach, friends, and family in case of mental health issues can clear the air and make the athlete energetic with positive insights and support from the peer to prevent unnecessary consequences. Since these acute conditions do not lead to life-threatening situations, care should be taken to avoid complications.