Risikoevaluation vor sportlicher Aktivität

Zusammenfassung

Eine (sport-)medizinische Untersuchung vor Aufnahme einer sportlichen Aktivität wird empfohlen, um potenziell bedrohliche kardiale Erkrankungen zu erkennen. Die Anamnese sollte hierbei auch die Familien- und Sportanamnese beinhalten. Ein obligater Bestandteil der Vorsorgeuntersuchung stellt das Ruhe-EKG dar. Bei der Interpretation des Ruhe-EKGs sind Kenntnisse über physiologische, sportbedingte Veränderungen essenziell. Atypische, nicht primär sportbedingte Veränderungen müssen weiter abgeklärt werden, um eine kardiale Grunderkrankung auszuschließen. Eine weiterführende Diagnostik wird entweder bei auffälligen Befunden, Vorhandensein von Risikofaktoren oder symptomatischen Personen durchgeführt.

Abstract

Preparticipation screening is recommended prior to physical activity. Beside the personal medical history family history and sports activity should be recorded. Rest-ECG is an obligatory part of preparticipation. For interpretation of rest-ECG knowledge about physiological alterations due to physical activity is necessary. Atypical not primarily sports-related alterations need further evaluation to rule out cardiovascular disease. Additional examinations are recommended in case of abnormal findings, in persons with risk factors or in symptomatic individuals.

Schlüsselwörter

Sportherz - plötzlicher Herztod - Sport - Prävention

Key words

Athleteʼs heart - sudden cardiac death - sports - prevention

• Literatur

• 1 Myerburg RJ, Castellanos A. Emerging paradigms of the epidemiology and demographics of sudden cardiac arrest. Heart Rhythm 2006; 3: 235-239
• 2 Zheng ZJ, Croft JB, Giles WH et al. Sudden cardiac death in the United States, 1989 to 1998. Circulation 2001; 104: 2158-2163
• 3 Rai M, Thompson PD. The definition of exertion-related cardiac events. Br J Sports Med 2011; 45: 130-131
• 4 Corrado D, Basso C, Rizzoli G et al. Does sports activity enhance the risk of sudden death in adolescents and young adults?. J Am Coll Cardiol 2003; 42: 1959-1963
• 5 Albert CM, Mittleman MA, Chae CU et al. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med 2000; 343: 1355-1361
• 6 Van Camp SP, Bloor CM, Mueller FO et al. Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc 1995; 27: 641-647
• 7 Harmon KG, Asif IM, Klossner D et al. Incidence of sudden cardiac death in National Collegiate Athletic Association athletes. Circulation 2011; 123: 1594-1600
• 8 Mittleman MA, Siscovick DS. Physical exertion as a trigger of myocardial infarction and sudden cardiac death. Cardiol Clin 1996; 14: 263-270
• 9 Harmon KG, Drezner JA, Maleszewski JJ et al. Pathogeneses of sudden cardiac death in national collegiate athletic association athletes. Circ Arrhythm Electrophysiol 2014; 7: 198-204
• 10 Pedoe DT. Sudden cardiac death in sport–spectre or preventable risk?. Br J Sports Med 2000; 34: 137-140
• 11 Northcote RJ, Flannigan C, Ballantyne D. Sudden death and vigorous exercise – a study of 60 deaths associated with squash. Br Heart J 1986; 55: 198-203
• 12 Lollgen H, Leyk D, Hansel J. The pre-participation examination for leisure time physical activity: general medical and cardiological issues. Dtsch Arztebl Int 2010; 107: 742-749
• 13 Corrado D, Basso C, Pavei A et al. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 2006; 296: 1593-1601
• 14 Drezner JA, Ackerman MJ, Anderson J et al. Electrocardiographic interpretation in athletes: the ‘Seattle criteria’. Br J Sports Med 2013; 47: 122-124
• 15 Scharhag J, Burgstahler C. Das Sportler-EKG: Aktuelle Interpretationen und Empfehlungen. Dtsch Z Sportmed 2013; 64: 352-356
• 16 Predel HG. Marathon run: cardiovascular adaptation and cardiovascular risk. Eur Heart J 2014; DOI: 10.1093/eurheartj/eht502.
• 17 Mangold S, Kramer U, Franzen E et al. Detection of cardiovascular disease in elite athletes using cardiac magnetic resonance imaging. Rofo 2013; 185: 1167-1174
• 18 Maron BJ, Thompson PD, Ackerman MJ et al. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation 2007; 115: 1643-1655
• 19 Corrado D, Pelliccia A, Bjornstad HH et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005; 26: 516-524
• 20 Steinvil A, Chundadze T, Zeltser D et al. Mandatory electrocardiographic screening of athletes to reduce their risk for sudden death proven fact or wishful thinking?. J Am Coll Cardiol 2011; 57: 1291-1296