Sports Cardiology

This chapter is comprised of 15 questions and answers, which are all purely clinically based. The corresponding answers to the questions can be found at the end of the chapter, each of which has a short explanation and at least one reference.

The Impact of COVID-19 on the Preparation for the Tokyo Olympics: A Comprehensive Performance Assessment of Top Swimmers

Background: The Olympic preparation of athletes has been highly influenced by COVID and post-COVID syndrome. As the complex screening of athletes is essential for safe and successful sports, we aimed to repeat the 2019-year sports cardiology screening of the Olympic Swim Team before the Olympics and to compare the results of COVID and non-COVID athletes. Methods: Patient history, electrocardiogram, laboratory tests, body composition analysis, echocardiography, cardiopulmonary exercise test (CPET) were performed. We used time-ranking points to compare swimming performance. Results: From April 2019, we examined 46 elite swimmers (24 ± 4 years). Fourteen swimmers had COVID infection; all cases were mild. During CPET there was no difference in the performance of COVID (male: VO2 max 55 ± 4 vs. 56.5 ± 5 mL/kg/min, p = 0.53; female: VO2 max 54.6 ± 4 vs. 56 ± 5.5 mL/kg/min, p = 0.86) vs. non-COVID athletes (male VO2 max 56.7 ± 5 vs. 55.5 ± 4.5 mL/kg/min, p = 0.50; female 49.6 ± 3 vs. 50.7 ± 2.6 mL/kg/min, p = 0.47) between 2019 and 2021. When comparing the time results of the National Championships, 54.8% of the athletes showed an improvement (p = 0.75). Conclusion: COVID infection with short-term detraining did not affect the performance of well-trained swimmers. According to our results, the COVID pandemic did not impair the effectiveness of the preparation for the Tokyo Olympics.

Immersion pulmonary oedema in a triathlete – a diagnostic challenge in sports cardiology

Immersion pulmonary oedema, also referred to as swimming-induced pulmonary oedema, is a form of pulmonary oedema which usually occurs during swimming in cold water. The condition is most common in triathlon athletes; it was first reported in military divers. The main symptoms include acute dyspnoea, cough, and occasionally haemoptysis, which usually subside within approximately 48 hours. The pathomechanism is not fully understood, but oedema is suspected to be due to an increased systemic vascular resistance that overloads the left ventricle. The diagnostic process can be challenging and require multiple stages to rule out a number of other possible conditions. In view of the circumstances in which incidents typically occur, immersion pulmonary oedema poses an immediate life threat to individuals involved in selected forms of physical activity, where survival is often determined by appropriate training of medical services.

2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease

The Task Force on sports cardiology and exercise in patients with cardiovascular disease of the European Society of Cardiology (ESC)

Recommendations on sports cardiology and exercise in patients with cardiac arrhythmias, channelopathies, CARDIOMOPATHIA AND implanted dEVICES ACCORDING TO THE LATEST GUIDELINES OF European Society of Cardiology – part 2

Competitive athletes should be screened for cardiovascular diseases associated with an increased risk of sudden cardiac death. Patients with arrhythmias, channelopathies, cardiomyopathies and cardiac implantable electronic devices should be assessed, and the level of acceptable physical activity should be established. It is crucial to personalize the guidelines and involve the patients in shared decision making. The following article provides an overview of exercise recommendations for patients with arrhythmias and cardiac implantable electronic devices on the basis of the 2020 ESC Guidelines on Sports Cardiology and Exercise. It was divided into two parts.