The athlete management
is complex and requires a concerted collaboration among nutritionists, coaches,
exercise physiologists, physicians, nurses, physical educators, and
psychologists, among others. For the best interest of the athlete physician is
expected to pursue medical decisions. The coach who is responsible of decision
making requires the input of a multidisciplinary team, the athlete, and family.
The physician’s role starts with pre-participation screening (history, physical
examination, and testing as needed) , as well as deciding on immediate
participation or return to play; involvement in the elaboration of policies
promoting wellness of athletes; and supervision of exercise
intensification in cardiac rehabilitation, promoting prevention and management
of sudden cardiac death in athletes, maximizing cardiovascular
performance without the use of drugs for Performance enhancing, and ensuring
the safety of sports arena (e.g., availability of automated external
defibrillators).
The sports medicine
includes not only competitive athletes but also anyone who exercises (amateur
or professionals). Although sports can confer the fitness to athletes, there is
a risk of sports-related sudden cardiac death. The tragic death of athlete
leads to negative response amoung society and media, although the general
benefits of exercise outweigh the risk. Commonly, sudden cardiac death is triggered
by a ventricular fibrillation (VF) or ventricular tachycardia degenerating into
VF(malignant tachyarrhythmia). The hypertrophic cardiomyopathy,
channelopathies, arrhythmogenic cardiomyopathy, or coronary congenital
abnormalities, among others are typically an underlying substrate for
arrhythmia trigger.
Sports
Cardiology has attained clinical and research advances in
cardiac imaging, electrophysiology and exercise physiology to enable better
diagnostic and therapeutic management of our patients. One recent advancement has
been to try and better differentiate athletic cardiac remodelling from
inherited cardiomyopathies and other pathologies.
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