(Statistically speaking, sports is healthy for your heart, but statistics can be tricky)

Aleš Linhart

Cor Vasa 2020, 62(4):351-352 | DOI: 10.33678/cor.2020.079  

(Cardiovascular adaptations to competitive sports - athlete's heart)

Vladimír Tuka, Kryštof Slabý

Cor Vasa 2020, 62(4):354-356 | DOI: 10.33678/cor.2020.039  

Intense physical activity creates hemodynamic stress to which the heart and the vascular system responds acutely and chronically adapts. Long-term adaptation leads to the image of the so-called athlete's heart. The athlete's heart is characterized by the harmonic/proportional dilation of all heart chambers and ventricle wall hypertrophy. These changes are also reflected in 12-lead ECG, which reflects both anatomical changes and vagotonia. One of the characteristics of the athlete's heart is its dynamic nature during sports season and their regression if the intensity of training is significantly reduced.

(Organization of preparticipation screening of athletes in the Czech Republic)

Kryštof Slabý, Vladimír Tuka

Cor Vasa 2020, 62(4):357-361 | DOI: 10.33678/cor.2020.062  

Mortality of competitive athletes is lower compared to general population but the relative contribution of sudden cardiac death may be higher. Prolonged exposition to physical exertion may contribute especially in predisposed persons or in concealed conditions. Incidence of sudden cardiac death is low (generally below 2/100,000 person years). Non-fatal injury to musculoskeletal and other organ systems is, on the other hand, frequent. The purpose of preparticipation examination is diagnostics of conditions with potential of sudden cardiac and non-cardiac death and prevention of non-fatal conditions caused by physical activity. There is clear legal regulation...

(Hypertrophic cardiomyopathy and sports - is it time for a change in strategy?)

David Zemánek

Cor Vasa 2020, 62(4):362-365 | DOI: 10.33678/cor.2020.081  

Hypertrophic cardiomyopathy has been associated with the risk of sudden cardiac death since it was described. It is also considered one of the most common causes of sudden death of young athletes. Therefore, competitive and in many cases recreational sports were not recommended for these patients. In the last few years, a number of findings have been published that shed new light on this issue. That is why today we choose a less restrictive approach, especially in the case of recreational sports. The aim of this article is to summarize current knowledge on this issue.

(Right ventricle in athletes)

Agáta Jeníšová, Josef Marek, Štěpán Havránek, Aleš Linhart

Cor Vasa 2020, 62(4):366-372 | DOI: 10.33678/cor.2020.060  

The right ventricle plays a crucial role in cardiovascular function in athletes. However, compared to the left ventricle, it often remains neglected. Despite that, arrhytmogenic cardiomyopathy, which affects predominantly the right ventricle, is one of the most frequent causes of morbidity in European athletes. Detection of the right ventricular disease and its differential diagnosis in athletic heart remains difficult. Physiological adaptation to exercise induces significant changes including chamber dilation. Specific criteria are needed to discern between pathology and physiological adaptation. The aim of this review is to summarize the hallmark...

(Dilated cardiomyopathy and myocarditis in an athlete)

Anna Chaloupka

Cor Vasa 2020, 62(4):373-378 | DOI: 10.33678/cor.2020.051  

Dilated cardiomyopathy and myocarditis are associated with an increased risk of cardiac arrhythmias. They represent one of the leading causes of sudden cardiac death in young athletes <35 years of age. Cardiac adaptation to an intense physical exercise is by itself linked to an array of electric, morphologic and functional changes comprising what is known as athletic heart. Discrimination of this physiologic adaptation from pathological findings is essential for risk stratification. The aim of this work is an overview of the current knowledge in differential diagnostics of dilated cardiomyopathy and myocarditis from the athletic heart, identification...

(Sports and cardiac arrhythmias)

Štěpán Havránek

Cor Vasa 2020, 62(4):379-385 | DOI: 10.33678/cor.2020.030  

Cardiac arrhythmias in competitive sports include serious ventricular tachycardias associated with structural heart diseases and arrhythmogenic syndromes, but also less risky supraventricular tachycardias. The most com- mon structural cause of sudden cardiac death is hypertrophic cardiomyopathy, followed by arrhythmogenic cardiomyopathy, dilated cardiomyopathy, long QT syndrome, early repolarization and WPW syndrome. Sudden cardiac death could occur in case of anomalous origins of coronary arteries and myocarditis. This review addresses also less risky arrhythmias which are more frequently observed in athletes, such as atrial fibrillation. Although...

(Sudden cardiac arrest/death during sports)

Vladimír Tuka, Jan Bělohlávek

Cor Vasa 2020, 62(4):387-389 | DOI: 10.33678/cor.2020.055  

Physical activity is an essential component of a healthy lifestyle, and its complex beneficial effect on almost all organs of the body makes it an ideal treatment modality. However, compared to resting conditions, physical activity represents a hemodynamic load. In predisposed athletes, exercise can lead to sudden cardiac arrest/death. Any death of an athlete or non-athlete is a traumatic event. Various strategies can be used to reduce the incidence of sudden cardiac arrest or to mitigate its effects; however, we cannot prevent all deaths. The manuscript summarizes basic knowledge about sudden cardiac death and the possibilities of its prevention.

(Cardiovascular system and sport diving)

Radek Pudil

Cor Vasa 2020, 62(4):390-394 | DOI: 10.33678/cor.2020.027  

Sport diving is one of the popular sports and recreational activities, which is performed by a relatively large group of athletes of different ages and levels of physical fitness. Sport diving represents two main disciplines: scuba diving and freediving. Diving requires good function of cardiovascular system. The aim of the paper is to summarize basic factors influencing cardiovascular system during diving, to provide basic information about diving physiological processes and to inform about some danger conditions that potentially interfere with diving (persistent foramen ovale, arterial hypertension, latent heart failure, arrhythmias, cardiac pacemakers,...

(Hypertension and sports)

Markéta Sovová, Eliška Sovová, Katarína Moravcová, Jaromír Ožana, Tereza Pokorná, Oldřich Masný

Cor Vasa 2020, 62(4):396-398 | DOI: 10.33678/cor.2020.049  

This review is focused on arterial hypertension in athletes, mainly the prevalence, recommendations for evaluation of athletes (including possible doping issues) and evaluation for participation in competitive sports. Also blood pressure during exercise is reviewed and its importance for assessment of cardiovascular risk.

(Athlete with pacemaker or cardioverter-defibrillator)

Otakar Jiravský, Bogna Jiravská Godula, Jan Chovančík, Radim Špaček, Libor Škňouřil, Martin Fiala

Cor Vasa 2020, 62(4):399-404 | DOI: 10.33678/cor.2020.031  

The Czech Republic is one of the leaders in the number of implantations of pacemakers and defibrillators in Europe. Increasingly, people in the younger generation may have one of the implants. Cardiologists are then confronted with questions and asked for recommendations about conditions a patient with an implanted pacemaker or defibrillator can engage in the sports activity. This care requires specific cardiological educa- tion along with an understanding of the athlete's mind and desires. The emerging sub-specialization of sports cardiology answers the above-mentioned requirements and becomes a bridge between the world of sports and the world of...

(Examination of the musculoskeletal system of an athlete with a focus on cardiorespiratory problems)

Barbora Imrichová, Monika Mikulášková, Eliška Sovová

Cor Vasa 2020, 62(4):405-408 | DOI: 10.33678/cor.2020.074  

The examination by a doctor of physical education (sports doctor) should also include an orientation examination of the musculoskeletal system, as the performance of each athlete is influenced not only by his movement skills and experience, but also by muscle coordination, physical parameters, and mental resistance to stress. When evaluating movement and sports load, we need to evaluate all components that participate in movement and its control. An unfavorable postural situation leads in the long run to the development of muscle imbalances, overloading of a certain area and subsequently to the development of microtraumas. The opportunity to carry...

Klaudikace u mladých pacientů

Miroslav Chochola

Cor Vasa 2020, 62(4):409-417 | DOI: 10.33678/cor.2020.071  

Vascular causes of exertional lower extremity pain are relatively rare, but may be the answer in athletes refractory to treatment for the more common overuse syndromes of the lower extremities. Important vascular etiologies to be considered are popliteal artery entrapment syndrome (PAES), iliac artery endofibrosis (IAE), popliteal artery aneurysm (PAA), cystic adventitial disease. It is important to differentiate these vascular causes from chronic musculoskeletal syndromes. Because all of these conditions may present with pain or intermittent claudication, imaging is crucial for differentiating them and directing management. The diagnostic workup involves...

(Doping, dietary supplements, and cardiovascular system)

Libor Vítek

Cor Vasa 2020, 62(4):419-422 | DOI: 10.33678/cor.2020.061  

Dietary supplements and various other supporting preparations are widely used in elite as well as hobby sport. However, their use might be associated with serious health risks involving cardiovascular impairment. These include direct damage of vessels and myocardium by substances prohibited because of their health impairing effects, but also by these substances contaminating allowed sports supplements, by mutual amplification of bioactive effects of multiple substances used often by athletes, or by biologically active, potentially cardiotoxic substances present in natural products. The spectrum of harmful cardiovascular effects is wide, from relatively...

(Coronary anomaly in athletes)

Radim Špaček, Otakar Jiravský, Libor Škňouřil

Cor Vasa 2020, 62(4):423-426 | DOI: 10.33678/cor.2020.050  

Coronary anomalies in athletes are rare findings. The incentive to look deeper into this subject is emphasized by the increased risk of sudden cardiac death, that is related to some of them. Diagnostic process is challeng- ing and treatment is complex. The aim of this article is to give its reader basic information about this often overlooked topic.

Complicated course of anomalous origin of right coronary artery in the left sinus of Valsava in a professional ice hockey player. A case report

Markéta Sovová, Eliška Sovová, Martin Sluka, Milan Kamínek, Martin Kocher, Jaromír Ožana

Cor Vasa 2020, 62(4):431-434 | DOI: 10.33678/cor.2020.075  

We present a case report of an athlete TS, 37-year-old ice hockey player with a malignant variant of anomalous right artery (AAOCA) and stenosis of the right artery. Owing to refusal to undergo cardiosurgery, a percutaneous coronary intervention (PCI) was done using a stent implantation with repetition of the procedure in one year because of stent restenosis. Four years after the first PCI, a new coronary angiogram showed 50% stenosis of the right coronary artery caused by the position of the stent. The man was indicated for aortocoronary bypass and this was carried out successfully in December 2019. The paper comments on the unusual course in an active...

Jitka Mlíková Seidlerová a kol.: Úvod do vnitřního lékařství

Jan Petrášek

Cor Vasa 2020, 62(4):436  

Společné odborné stanovisko Sekce sportovní kardiologie České asociace preventivní kardiologie ČKS a Sekce sportovní kardiologie České společnosti tělovýchovného lékařství

Vladimír Tuka, Eliška Sovová, Bogna Jiravská Godula, Otakar Jiravský, Peter Kubuš

Cor Vasa 2020, 62(4):427-430 | DOI: 10.33678/cor.2020.077  

Elite and competitive athletes are not spared from the risk of COVID-19 infection. Sports medicine physicians, general practitioners, and cardiologists may be asked about the athlete's return to sport after COVID-19. Globally, several guidelines have emerged that generally take a more cautious approach to resuming training and intense physical activity. The following recommendations seek to summarize current views on the return to sports for athletes and provide guidance for the assessing physician.