Correspondence
Utilization and Implementation of Sports Medical Screening Examinations – Survey of More Than 10 000 Long-Distance Runners: Sudden Cardiac Death
Dtsch Arztebl Int 2008; 105(51-52): 900. DOI: 10.3238/arztebl.2008.0900a


It has been sufficiently confirmed that cases of sudden cardiac death during sports activity—even in celebrated athletes—are often caused by cardiomyopathies or other structural cardiac anomalies, which were not known during the person's lifetime. Coronary heart disease is also increasingly found at a younger age. The youngest patient with a coronary bypass who is personally known to me was operated on at the age of 25; the youngest patient known to me who died suddenly from infract-related cardiac death without any preceding symptoms (diagnosis made at postmortem) was only 24.
In view of these aspects it seems to make sense to extend the apparative part of a sports medical screening examinations to include a 12–lead exercise ECG and echocardiography. Both methods can make a great contribution to detecting hemodynamically relevant coronary insufficiencies, potentially life threatening exercise induced arrhythmias, cardiomyopathies, right ventricular dysplasias and aortic stenoses even at clinically inapparent stages. Such additional diagnostics are likely to facilitate a far wider reaching diagnostic clarification that would enable to select early on those subjects with a potential risk factor. Future guidelines should reflect this state of affairs.
DOI: 10.3238/arztebl.2008.0900a
Prof. Dr. med. Jörg Piper
Meduna-Klinik
Clara-Viebig-Str. 4
56864 Bad Bertrich, Germany
E-Mail: webmaster@prof-piper.de
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