On your marks, get set… AND MY HEART?

Pre-marathon cardiovascular evaluation Importance: In recent years there´s been a significant increase in the performance of popular marathons and participants in them. However, most of these athletes do not undergo adequate precompetitive cardiovascular control in order to reduce cardiovascular risk, specially sudden death. Sudden death is understood as the unexpected and natural death produced as a consequence of heart failure. The incidence in athletes is 1.6 deaths per 1,000 (higher than in non-athletes, which is 0.75 deaths per 10,000), among the main causes are coronary atheromatous disease (40%) followed by heart diseases such as hypertrophic heart disease, arrhythmogenic right ventricular dysplasia or coronary anomalies. 20% of sudden deaths occur in patients without symptoms or pre-existing heart disease. In surveys of amateur marathoners almost half of them had never had any precompetitive cardiological control and even more striking is that close to 30% responded having symptoms during exercise: chest pain, palpitations or loss of consciousness, which considerably increase the mortality. Athletes are considered healthy people so they often underestimate some minor symptoms without knowing that they are at risk. Precompetitive evaluation: The objective is to make the athletes aware of cardiovascular of the need of medical check-ups before they begin their intense sports activity. In the initial screening, a correct interrogation should be carried out, collecting all the personal and family antecedents, symptoms related to the cardiovascular sphere: chest pain, syncope, palpitations, complete physical examination (which includes taking blood pressure and an Electrocardiogram). In the vast majority of participants, this initial evaluation is sufficient to eliminate the possibility of some type of structural heart disease, coronary disease or malignant arrhythmias that could potentially cause cardiovascular complications. In selected cases, the assessment may be supplemented, , with an Ergometry and/or an Echocardiogram, which may provide more information about these pathologies. It's a contribution from Drs. Juan Tourn and Federico Superchi