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Monday, April 13, 2015
Sports: yes but not too much!
European Heart Journal: The benefits of exercise are irrefutable. Individuals engaging in
regular exercise have a favourable cardiovascular risk profile for
coronary artery disease and reduce their risk of myocardial infarction
by 50%. Exercise promotes longevity of life, reduces the risk of some
malignancies, retards the onset of dementia, and is as considered an
antidepressant. Most of these benefits are attributable to moderate
exercise, whereas athletes perform way beyond the recommended levels of
physical activity and constantly push back the frontiers of human
endurance. The cardiovascular adaptation for generating a large and
sustained increase in cardiac output during prolonged exercise includes a
10–20% increase in cardiac dimensions. In rare instances, these
physiological increases in cardiac size overlap with morphologically
mild expressions of the primary cardiomyopathies and resolving the
diagnostic dilemma can be challenging. Intense exercise may infrequently
trigger arrhythmogenic sudden cardiac death in an athlete harbouring
asymptomatic cardiac disease. In parallel with the extraordinary
athletic milieu of physical performances previously considered
unachievable, there is emerging data indicating that long-standing
vigorous exercise may be associated with adverse electrical and
structural remodelling in otherwise normal hearts. Finally, in the
current era of celebrity athletes and lucrative sport contracts, several
athletes have succumbed to using performance enhancing agents for
success which are detrimental to cardiac health. This article discusses
the issues abovementioned, which can be broadly classified as the good,
bad, and ugly aspects of sports cardiology.