Cardiovascular disease in athlètes

The athletic heart syndrome is a physiologic adaptation of the heart in response to chronic exercise training and may be difficult to distinguish from cardiac pathology, such as hypertrophic cardiomyopathy. Specific electrocardiographic and echocardiographic changes accompany this syndrome. Sudden cardiac death in athletes is a relatively rare phenomenon, occurring in approximately one in 200,000 high school athletes per year. In athletes over the age of 35 years, the prevalence is unknown. The most common cause of sudden cardiac death in young athletes in the United States is hypertrophic cardiomyopathy. Other causes are anomalous coronary arteries, myocarditis, arrhythmogenic right ventricular dysplasia, and aortic rupture/dissection due to Marfan's syndrome. In older athletes, coronary artery disease is by far the leading cause of sudden cardiac death. The American Heart Association has addressed the issues surrounding sports preparticipation evaluation and has published guidelines concerning the history and physical examination as well as the use of screening electrocardiography and echocardiography.