5 The risk of cardiovascular death or isolated coronary artery disease is significantly lower in physically active and fit individuals, but the risk of sudden death increases 2–4.5 fold during high-intensity exercise. SCD is the leading cause of death (75–85%) 3,4 in athletes during sports. 1 Physical exercise is a very important component of primary and secondary cardiovascular prevention, and the 2012 European Society of Cardiology ( ESC) guidelines on cardiovascular disease prevention recommend 2.5–5 hours/week of moderate-intensity physical activity or 1–1.5 hours/week of vigorous-intensity exercise, the benefits being greater with more hours of exercise. Sudden cardiac death ( SCD) in an athlete is a tragic event that generates significant media attention and discussion throughout society as to whether everything possible had been done to prevent it.Īn athlete has been defined as an individual engaged in regular physical training and participating in official sports competition with an emphasis on excellence and achievement. É também objetivo desta revisão dar a conhecer a problemática da inclusão do eletrocardiograma no programa de rastreio pré-desportivo, as perspetivas americana e europeia, e os dados mais recentes sobre a sensibilidade, especificidade e custo-efetividade do uso do eletrocardiograma em atletas. Esta revisão pretende reunir a informação mais atual sobre as alterações eletrocardiográficas consideradas benignas ou patológicas encontradas tipicamente em atletas e analisar, de forma crítica, os critérios mais recentes para a classificação do eletrocardiograma nesta população (os Critérios de Seattle), comparando-os com as guidelines anteriores e com os estudos mais recentes sobre o tema. Assim, urge definir quais os padrões eletrocardiográficos que «permitem» ou, por outro lado, «proíbem» a prática desportiva, diferenciando-os em função do género, etnia e idade. Algumas destas alterações do eletrocardiograma são consideradas normais/fisiológicas em atletas, enquanto outras traduzem, efetivamente, doença cardíaca de base, com potencial de causar morte súbita cardíaca. A prática regular de exercício físico causa uma remodelagem cardíaca, tanto a nível mecânico como elétrico, conhecida como «coração de atleta», que se repercute num eletrocardiograma considerado «anormal» quando comparado com o da população geral. É um evento trágico, com grande impacto nos média, gerando discussão dentro da comunidade no intuito de perceber se tudo foi feito para o evitar. This article also examines the question of including ECGs in preparticipation screening programs, the US and European approaches to the subject, and the most up-to-date data on the sensitivity, specificity and cost-effectiveness of the ECG in athletes.Ī morte súbita cardíaca é a principal causa de morte em atletas durante a prática desportiva. The purpose of this review is to present the latest data on the electrocardiographic changes considered benign or pathological that are typically found in athletes and to critically analyze the most recent criteria for classifying ECGs in this population (the Seattle criteria), comparing them with previous guidelines and with the latest studies on the subject. There is thus an urgent need to define the electrocardiographic patterns that allow or prohibit participation in sports, and to differentiate them in terms of gender, ethnicity and age.
Some of these electrocardiographic changes are considered normal or physiological in athletes, while others suggest underlying cardiac disease with the potential to cause sudden cardiac death. Regular physical exercise causes cardiac remodeling at both the mechanical and electrical level, known as athlete's heart, resulting in an electrocardiogram (ECG) considered abnormal compared with the ECGs of the general population. It is a tragic event that generates significant media attention and discussion throughout society as to whether everything possible had been done to prevent it. Sudden cardiac death is the leading cause of death in athletes during sport.
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