Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Athletes heart


Published on

athlets heart

Published in: Health & Medicine
  • Be the first to comment

Athletes heart

  2. 2. HISTORY  Heneschen(1890) used physical examination to determine increased cardiac dimensions in elite nordic skiers.  Eugene darling in the same year in rowers of harvard university. 2/1/2015 2ATHLETE'S HEART
  3. 3.  Paul dudely white(1900) studied radial pulse rate among boston marathon competitors and was the first to report marked resting sinus bradycardia in long distance runners. 2/1/2015 3ATHLETE'S HEART
  4. 4.  Earlier it was thought to be beneficial adaptations to exercise.  But later it was postulated as a form of overuse pathology and prolonged participation in sport can lead to premature cardiovascular system collapse. 2/1/2015 4ATHLETE'S HEART
  5. 5.  Athlete’sheart syndrome , a term often applied to athletic patient who present with subjective symptoms or abnormal CVS findings. 2/1/2015 5ATHLETE'S HEART
  6. 6.  Aerobic /endurance exercises execises requiring primarily an increase in o2 transpot. 2/1/2015 6ATHLETE'S HEART
  7. 7.  Resting /strength exercises exercises primarily stressing the skeletal muscle. 2/1/2015 7ATHLETE'S HEART
  8. 8. PHYSIOLOGY  Physical activity acutely increases o2 demand which increases cardiac output (Q) and arteriovenous difference (A- V)O2.  1 lit of oxygen consumption (VO2) produces 5-6 lit increase in Q. 2/1/2015 8ATHLETE'S HEART
  9. 9.  The CV response to exercise has both external and internal work rate,  External work rate isVO2 required for exercise task and is direct determination of Q.  Internal work rate is MO2 required for exercise task and is direct determinant of HR 2/1/2015 9ATHLETE'S HEART
  10. 10. 2/1/2015ATHLETE'S HEART 10 Repetitive excercises to increase exercise capacity IncreasesVO2 Increased Q(HR and SV) Increased stroke volume
  11. 11.  The increase in SV means that performing the same exercise task which requires the sameVO2 can be performed at a slower HR and a lower MO2 or internal work rate. 2/1/2015ATHLETE'S HEART 11
  12. 12.  The physiologic mediators of these CV adaptations may be produced by increased resting vagal tone and reduced resting sympathetic tone resulting in resting sinus bradycardia 2/1/2015ATHLETE'S HEART 12
  13. 13. LEFT VENTRICLE  Studies revealed LV hypertrophy and dilation.  showed increased LV end diastolic diameter and small percentage had LV wall thickness more than 13mm. 2/1/2015ATHLETE'S HEART 13
  14. 14. MORGANROTH HYPOTHESIS  studies demonstrated concentric LV hypertrophy in strength training and eccentic LV hypertrophy in aerobic training. 2/1/2015ATHLETE'S HEART 14
  15. 15. 2/1/2015ATHLETE'S HEART 15
  16. 16. 2/1/2015ATHLETE'S HEART 16
  17. 17. 2/1/2015ATHLETE'S HEART 17
  18. 18. Figure 3. Impact of different clinical variables on LV end-diastolic cavity dimensions in a large population of male and female elite athletes. Maron B J , and Pelliccia A Circulation. 2006;114:1633- 1644 Copyright © American Heart Association, Inc. All rights reserved.2/1/2015 18ATHLETE'S HEART
  19. 19.  On LV systolic function demonstrated preserved LV ejection fraction except for one study  On LV diastolic function improved LV diastolic function is essential mechanism in preserving stroke volume 2/1/2015ATHLETE'S HEART 19
  20. 20. RIGHT VENTRICLE  Cardiac remodelling is not confined to LV  Scharhag et al study demonstrated RV enlargement parallels LV enlargement supporting the concept of biventricular enlargement. 2/1/2015ATHLETE'S HEART 20
  21. 21. AORTA  Experiences a significant hemodynamic load during exercise.  Aerobic exercise- high volume aortic flow with modest systemic hypertension  Strength exercises-normal volume with profound systemic hypertension. 2/1/2015ATHLETE'S HEART 21
  22. 22.  Babee et al studies revealed increased aortic dimensions in strength exercise training.  Pellica et al studies revealed incresed aortic dimensions in aerobic training exercises. 2/1/2015ATHLETE'S HEART 22
  23. 23. LEFT ATRIUM  Studies confirmed high prevalnce of left atrial enlargement in athletes  SEX AND RACE 2/1/2015ATHLETE'S HEART 23
  25. 25. A, An electrocardiogram of a 46-year-old male triathlete who presented after long-standing palpitations and a recent episode of syncope. Baggish A L , and Wood M J Circulation. 2011;123:2723- 2735 Copyright © American Heart Association, Inc. All rights reserved.2/1/2015 25ATHLETE'S HEART
  26. 26. ARRHYTHMIAS Brady arrhythmias such as  Sinus bradycardia  Junctional bradycardia  AV block  The reduced AV conduction velocity may take accessory pathway such as WPW syndrome. 2/1/2015ATHLETE'S HEART 26
  27. 27.  Increased vagal tone may be responsible for early repolarisation and ST abnormalities. 2/1/2015ATHLETE'S HEART 27
  28. 28. 2/1/2015ATHLETE'S HEART 28
  29. 29. VALVE DISEASE IN ATHLETS AORTIC STENOSIS  Careful evaluation of symptoms and maximal exercise testing  Warm up dyspnea indicates clinically important AS 2/1/2015ATHLETE'S HEART 29
  30. 30. AORTIC REGURGITATION  Generally tolerate AR,because of increased HR during exercise, decreases diastole and regurgitant.  Rarely restrict the patients with AR unless there is ventricular deterioration. 2/1/2015ATHLETE'S HEART 30
  31. 31. AORTIC DISSECTION IN BAV  We do not restrict the patient unless the patient aortic root dimensions are more than 45 mm  Annual screening. 2/1/2015ATHLETE'S HEART 31
  32. 32. SYNCOPE  Majority of syncope in athlete’s is attributed to neurocardiogenic syncope.  Manifests in the immediate post exercise testing owing to sudden reduction in venous return, which facilitates transient cerebral hypoperfusion. 2/1/2015ATHLETE'S HEART 32
  33. 33.  Syncope during exercise, there is a possibility of malignant arrhythmias, valvular heart disease and myocardial ischemia. 2/1/2015ATHLETE'S HEART 33
  34. 34. DECREASED EXERCISE CAPACITY  Hyperthyroididm  Exercise induced asthma  Disease of the skeletal muscles  Anemia  AF  Viral illness 2/1/2015ATHLETE'S HEART 34
  35. 35. ELEVATED CARDIAC ENZYMES  Increase in cTnT occurs in athletes following prolonged exertion.  Endurance athletes were documented to have increased concentrations of CK-MB and satellite cells in their leg muscles. 2/1/2015ATHLETE'S HEART 35
  36. 36. 2/1/2015ATHLETE'S HEART 36
  37. 37. 2/1/2015 37ATHLETE'S HEART
  38. 38. 2/1/2015ATHLETE'S HEART 38