Cardiac Screening For Rowers

[old] dr dave · Post by **[old] dr dave** » January 18th, 2006, 2:25 pm

i am a GP with a interest in cardiology , particularly in sports related sudden cardiac death(SCD), which i know sounds a bit depressing... but i was wondering what members general awareness and thoughts were about this subject. Every Year approx 300 young well people under 35 die suddenly from SCD in the uk, the average age is 17yrs and males are predominantly affected (ratio 10:1) . Ironically playing and training sports also increses the risk by 2-3 times. Most elite level athletes are screened for the underlying cardiac causes' but so far screening for mass participants is almost nil. Also physical examination rarely identifies those at risk , so when you hear advice saying please consult your doctor before commencing exercise , unless the doctor is doing an ecg or better arranging an echocardiogram then there is little chance that any abnormality is going to be detected. Interestingly in Italy for the last 25 yrs cardiac screening has been mandatory for all those playing sport. and there is strong evidence that the incidence of SCD has been reduced. in 2005 the IOC and european society of cardiologists have advocated screening for all playing sport between 14-35 yrs. but when one reads about the 2 under 35 yr olds who died during the last great north run , then there is no comment about underlying heart conditions so i thing general awareness out there is rather limited... i would be very interested to read your thoughts about this subject as i think for too long people have not been given the real info about the risk and benefits of screening and enjoying sport safely. thanks dave evans

[old] John Rupp · Post by **[old] John Rupp** » January 18th, 2006, 3:08 pm

There is quite a bit of information about sudden cardiac deaths caused by ingestion of aspartame and msg. You can find out more about this on Google. However it's easy enough to just stop eating foods with these things, and advise others the same.

[old] gaffano · Post by **[old] gaffano** » January 18th, 2006, 4:19 pm

I had extensive cardiac screening due to my family history and genetic high cholesterol after I complained of chest discomfort after excercise. I had echocardiagram, EKG, x-rays, Holtor monitor, and Nuclear stress test. My insurance paid for this due to family/self cardiac issues. I am sure it cost several thoudand dollars. I am 34 M in USA. Managed care here focuses on saving $$, so they will never go for approving mass detailed expensive testing for athletes.

[old] Citroen · Post by **[old] Citroen** » January 18th, 2006, 8:49 pm

<table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td><div class='genmed'>QUOTE(dr dave @ Jan 18 2006, 06:25 PM)</div></td></tr><tr><td class='quote'>i would be very interested to read your thoughts about this subject as i think for too long people have not been given the real info about the risk and benefits of screening and enjoying sport safely. thanks dave evans </td></tr></table> I've sent you a PM.

[old] brooks · Post by **[old] brooks** » January 20th, 2006, 9:28 pm

Interesting discussion, at least for indoor rowing/ med student nerds like myself! The most common cause of sudden death in adolescents is hypertrophic cardiomyopathy, an inherited disorder that produces a malformed wall of the heart that is prone to obstructing cardiac output, especially during exertion. Has nothing to do with cholesterol or MSG. On the other hand, some young folks have inherited disorders of cholesterol processing, and they start clogging their coronary arteries far ahead of schedule. This may account for the deaths in the 35 year-old crowd. Even more rare is the phenomenon of "commotio cordis," the cardiac arrest that can occur when the very young athelete is struck in the chest with a ball, say, or a stick. The flexible chest wall in the child allows the energy to penetrate through to the heart. If that impact occurs at a specic point in the cardiac cycle, a fatal heart rhythm. In the absence of a suggestive family history or symptoms, I'm not sure what the value would be in aggresive screening. Anything beyond a good history and physical may be just throwing away money. I think I would be more concerned about getting hit by a car on the way to the race/game/regatta!

[old] Godfried · Post by **[old] Godfried** » January 21st, 2006, 5:35 am

<table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td><div class='genmed'>QUOTE(brooks @ Jan 21 2006, 03:28 AM)</div></td></tr><tr><td class='quote'>I think I would be more concerned about getting hit by a car on the way to the race/game/regatta! </td></tr></table> In 2004 in the US 62,636 people were killed in traffic , that is 14,5 / 100,000. 163,000 died of sudden cardiac arrest , 55 / 100,000. Sport related ? I got lost in the article : <a href='http://www.americanheart.org/presenter. ... ifier=1478' target='_blank'>American Heart Association</a>

[old] John Rupp · Post by **[old] John Rupp** » January 21st, 2006, 1:17 pm

<table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td><div class='genmed'>QUOTE(Godfried @ Jan 21 2006, 01:35 AM)</div></td></tr><tr><td class='quote'>In 2004 in the US 62,636 people were killed in traffic , that is 14,5 / 100,000. 163,000 died of sudden cardiac arrest , 55 / 100,000. Sport related ? I got lost in the article : <a href='http://www.americanheart.org/presenter. ... ifier=1478' target='_blank'>American Heart Association</a> </td></tr></table> Those are quite arresting and sobering statistics, Godfried. As compared with those who inherited traffic accidents, four times as many people died from bad doctors. Yikes! There's a lesson there. If you value your life, stay away from the medical quacks!

[old] ljwagner · Post by **[old] ljwagner** » January 22nd, 2006, 11:09 am

Dr Dave: What about valve abnormalities ? Have any deaths in young people been due to those ? Gaffano: See My Bypass Surgery under Health & Fitness. Why skip an angiogram if there is a problem ? My profile last December: non-smoker non-drinker exercise regularly 4 decades good diet parent and grandparent with heart attacks at 57 2 incidents of shortness of breath in 3 years, with mild chest pain. - resting EKGs negative. - Echo Stress EKG showed minor mitral regurgitation. 12/23/2006 moderate chest pain - resting EKGs negative. diagnosis: anxiety result: nearly died on vacation due to 99% clogged main cardiac artery

[old] gaffano · Post by **[old] gaffano** » January 22nd, 2006, 11:42 am

<table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td><div class='genmed'>QUOTE(ljwagner @ Jan 22 2006, 10:09 AM)</div></td></tr><tr><td class='quote'>Dr Dave: What about valve abnormalities ? Have any deaths in young people been due to those ? Gaffano: See My Bypass Surgery under Health & Fitness. Why skip an angiogram if there is a problem ? My profile last December: non-smoker non-drinker exercise regularly 4 decades good diet parent and grandparent with heart attacks at 57 2 incidents of shortness of breath in 3 years, with mild chest pain. - resting EKGs negative. - Echo Stress EKG showed minor mitral regurgitation. 12/23/2006 moderate chest pain - resting EKGs negative. diagnosis: anxiety result: nearly died on vacation due to 99% clogged main cardiac artery </td></tr></table> ljwagner...Did you have a nuclear stress test? Mine came back OK..according to my Excercise Cardiologist...He gave me the go ahead to work out close to my MHR. Diagnosis...Anxiety. I am normally sceptical, however, in truth when I looked back and analized the times I have felt similar chest discomfort/fluttering, it has always been around a very stressful time in my life: death of parent, girlfriend breakup, working near WTC , seeing 2nd plane hit building.. during 9/11, etc. (which caused some post traumatic stress disorder) I am 34 M, 190, 6 ft, 18%BF, BP 110/70 (some white coat hyper-tension 130/90), non-smoker, ride my bike at 65-90%MHR @50-100miles/wk, row 5000m 3 days/wk, surf, weight lift. My natural cholesterol through no diet, or low fat-diet, or vegetarian diet (never tried carb restricted diet), etc never got below 200 Total (230ish norm) 160 LDL, 45 HDL. When I was on 10mg of Lipitor: 160 Total, 100 LDL. Father smoked on/off till 45, crappy diet, overweight, no -excercise had bypass at 55, valves replaced at 62, type 2 diabetes since 35, died at 69 from pulmonary failure. My brother has similar lipid profile as me. Also, ljwagner, have you always had non-diet related high cholesterol? When did you find out? 20s, 30s, 40s, 50s? Did you bring it down? How? Did you have a CT scan for calcification prior to bypass?

Concept2 Forum

Cardiac Screening For Rowers

Training

Training

Training

Training

Training

Training

Training

Training

Training