HomeHealth articlesprevention of cardiovascular eventsWhat Is the Best Way to Care for an Athlete’s Cardiac Health?

What Should Be Done in Sports to Protect the Cardiovascular System?

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Athletes with underlying cardiac conditions are susceptible to sudden cardiac arrest during exercise. This article reviews cardiac care among athletes.

Medically reviewed by

Dr. Muhammad Zohaib Siddiq

Published At May 8, 2023
Reviewed AtJuly 12, 2023

Introduction:

Recently, sports activity and physical fitness awareness have increased. Although vigorous exercise reduces the risk of cardiovascular disease, severe activity has significant negative cardiac outcomes. The cardiovascular system is essential in athletes, and it's critical to distinguish between disease and physiologic changes in response to exercise or stressful sports events. Sports cardiology was introduced to evaluate the cardiovascular condition and guide athletes in decision-making and participation in specific sports events.

How Does the Cardiovascular System Alter With Exercise?

The cardiovascular system adapts to repetitive exercise or mild to moderate static or dynamic skeletal muscle activity. It is often characterized by structural and functional changes. Static activities like weight lifting and track and field throwing result in muscle contraction, which increases systemic vascular resistance and arterial blood pressure. In contrast, dynamic activities like cricket, golf, volleyball, and running develop the rhythmic contraction and relaxation of skeletal muscle groups and increase cardiac output. Chest pain, breathlessness, fatigue, and exercise intolerance are indications of increased cardiac output in response to dynamic activity.

What Is Cardiac Output and How Is It Affected by Intense Exercise?

The cardiac output is the blood pumped from the ventricles, calculated by heart rate (HR) and stroke volume (SV). Initially, the heart rate increases even before a physical activity that releases neurotransmitters. Constant, repetitive exercise increases cardiac output, which aids in oxidative metabolism in the skeletal muscles. In addition, blood vessel constriction reduces the blood flow to the kidneys, liver, stomach, and intestines. On the other hand, the cardiac output decreases or remains the same when practicing in a hot environment.

What Are the Cardiac Symptoms Experienced by Athletes During Training?

Chest pain and syncope, known as exertional symptoms, are relieved by physical rest. However, these symptoms can occur during or after exercise and require immediate care.

  • Chest Pain: Chest pain in athletes can be caused by various factors, including gastrointestinal, pulmonary, and musculoskeletal disorders. A thorough examination, history, an electrocardiogram (ECG), and electrocardiography (evaluation of cardiac structure) are required.

  • Syncope: Syncope is the transient loss of consciousness, and postural tone can be either physiological or pathological due to the pooling of blood within the vessels that reduces blood supply to the brain. Unfortunately, it can lead to a pathological condition like arrhythmia (irregular heartbeat), followed by a dramatic collapse. In addition, left ventricular outflow obstruction occurs due to left ventricle or aorta defects. The diagnosis of syncope is the same as chest pain; additionally, rhythm is calculated.

  • Palpitation: Palpitation is an irregular heartbeat that occurs during excitement, fear, mental stress, and physical exercise. Its experience without any of these triggering factors is more likely to cause pathological arrhythmias.

  • Other Symptoms: Exercise intolerance may also result in additional symptoms, including breathlessness, chest pain, dizziness, and generalized fatigue.

What Is the Possible Cardiac Risk Factor Among Athletes?

Most athletes have the possible risk factors of hypertension, aging, and atherosclerosis.

  • Hypertension: Hypertension, or increased blood pressure, is common among athletes. Exercise-induced blood pressure measurements may help identify people with hidden hypertension. Treatment modalities include lifestyle modification and medications such as vasodilators and angiotensin-converting enzyme inhibitors.

  • Atherosclerotic Coronary Artery Disease: This is a cardiovascular condition characterized by the accumulation of cholesterol within the blood vessels of the coronary artery and is most likely to cause sudden cardiac arrest in older athletes. The cardiac rehabilitation program is specially designed for patients with coronary heart disease.

What Is the Best Way to Care for an Athlete’s Cardiac Health?

Cardiac vascular assessment and treatment planning reduce the risk of cardiovascular disorders. Sports cardiology is indicated in the cardiovascular condition treatment plans of athletes and active people who have or do not have cardiovascular conditions. Sports cardiology focuses on congenital or genetic heart disease, heart failure, pediatric heart care, and inherited cardiac disease. It also has a specific role in assessing exercise-induced cardiac remodeling and determining eligible sports and exercises for athletes with cardiovascular conditions to ensure safety with sports activity. Sports cardiological therapy differs from person to person based on symptoms, acquired diseases, and pre-existing conditions.

Management of Pre-Existing Cardiac Diseases:

The primary care of pre-existing conditions is based on family history, cardiac or vascular symptoms, a physical examination, and an electrocardiogram. This screening aids in determining the risk of cardiovascular disease during sporting events. Some pre-existing cardiac conditions are:

  • Hypertrophic Cardiomyopathy: Cardiomyopathy is a genetic condition associated with sudden death when exercising. Treatment management involves medication and implantable defibrillator placement.

  • Myocarditis: Myocarditis is an inflammation of the heart muscle associated with chest pain, arrhythmia, cardiac failure, and an upper respiratory tract infection. The treatment includes medications for regulating cardiac function, and the device is incorporated in severe cases.

  • Atrial Fibrillation: It is a mathematical condition characterized by irregular heartbeats. Symptoms include fatigue, heart palpitations, trouble breathing, and dizziness. If left untreated, it can result in a stroke. The treatment involves medication to regulate the heartbeat and a blood thinner to treat blood clots.

  • Acquired Disease Care and Management: The sudden onset of chest pain, dyspnea (breathlessness), fainting or syncope, and heart palpitations without any pre-existing condition requires immediate monitoring of any development of heart problems and eventually evaluating the safest time to return to sports again.

What Is the Role of Sports Cardiology in Cardiovascular Management?

Sports cardiology has a significant role in athletes' safety evaluation and physical examination. A customized treatment plan for specific activities and sports is recommended based on cardiac (heart) health. The protocol of sports cardiology involves:

  • Performance assessment.

  • Cardiovascular evaluation includes a history and physical exam, an electrocardiogram, an echocardiogram, and cardiopulmonary exercise testing.

  • Risk factors evaluation followed by care.

  • Sports clearance after a cardiac and non-cardiac illness and surgery.

Conclusion:

Sports cardiology has been blooming recently with unique knowledge and skill specific to particular events and sports among athletes. The sports cardiology public policy related to sports and exercise safety is to develop, rehearse, and refine emergency action plans specific to the athletic event and typical exercise. The authenticated certificate provided by the sports cardiologist permits rejoining of athletes in the sports event.

Dr. Muhammad Zohaib Siddiq
Dr. Muhammad Zohaib Siddiq

Cardiology

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