Exercise‐related severe cardiac events

Abstract

Physical activity has benefits on health. However, there is a small risk of effort-related adverse events. The aim of this study is to describe exercise-related severe cardiovascular events and to relate them with the type of sport performed. We performed a ten-year retrospective study in eight Spanish cardiac intensive care units. Adverse cardiac events were defined as acute myocardial infarction, cardiac arrest or syncope related to physical activity. From 117 patients included, 109 were male (93.2%), and mean age was 51.6 ± 12.3 years; 56 presented acute myocardial infarction without cardiac arrest (47.9%), 55 sudden cardiac death (47.0%) and six syncope (5.1%). The sports with higher number of events were cycling (33%-28.2%), marathon or similar running competitions (19%-16.2%), gymnastics (18%-15.3%) and soccer (17%-14.5%). Myocardial infarction was observed more frequently in cyclists compared to other sports (69.7% vs 39.3%, P = .001). The most common cause of sudden cardiac death was myocardial infarction in those >35 years (23%-63.9%) and idiopathic ventricular fibrillation in younger patients (5%-62.5%). Significant coronary artery disease was present in 85 (79.4%). Only one patient with cardiac arrest presented with a non-shockable rhythm (asystole). Eleven patients (9.4%) died during hospitalization; in all cases, they had presented cardiac arrest. All discharged patients were alive at the end of follow-up. Exercise-related severe cardiac events are mainly seen in men. Coronary heart disease is very frequent; about half present acute myocardial infarction and the other half cardiac arrest. In our cohort, prognosis was good in patients without cardiac arrest.

Optical Coherence Tomography for the Diagnosis of Exercise-Related Acute Cardiovascular Events and Inconclusive Coronary Angiography

“…Some previous investigations described clinical and angiographic characteristics of exercise-related ACS and SCD [ 5 , 19 , 20 , 22 , 29 ], but to our knowledge, this is the first OCT study in this particular subgroup of sport-triggered ACS and SCD patients with nonsignificant stenosis on angiography.…”

“…Some previous investigations described clinical and angiographic characteristics of exercise-related ACS and SCD [ 5,19,20,22,29], but to our knowledge, this is the first OCT study in this particular subgroup of sport-triggered ACS and SCD patients with nonsignificant stenosis on angiography. e individuals of our study were predominantly middle-aged men with low cardiovascular risk burden in agreement with prior studies [5,15,19,20,30].…”

“…Coronary angiography is often indicated to rule out coronary artery disease in patients admitted for ACS. However, about 5-20% of ACS patients present with nonsignificant stenosis and ambiguous angiographic findings [20][21][22][23]. Optical coherence tomography (OCT) is an intravascular image technique with high spatial resolution, permitting to accurately detect unstable plaques, plaque composition, minimal lumen area, and the presence of alternative conditions associated with ACS (i.e., spontaneous coronary dissection, coronary spasm, or myocardial bridging).…”

Função Diastólica e Biomarcadores de Participantes de Caminhada de Longa Distância

“…A velocidade de corrida competitiva em meia maratona ou maratona solicita maiores demandas energéticas e metabólicas e amplia a chances de desfechos cardiovasculares, principalmente em indivíduos não condicionados. 14 No nosso trabalho a velocidade média foi de 7,6 km/h, bem inferior ao modelo de maratona e meia maratona e, portanto, com menor demanda energética e metabólica dos participantes.…”

Medical encounters (including injury and illness) at mass community-based endurance sports events: an international consensus statement on definitions and methods of data recording and reporting

“…The risk of sudden death during endurance sports events such as the half-marathon (21km) and the marathon (42km) is well described and varies between 0.25 to 3 per 100 000 race entrants for marathons [2,13,[19][20][21][22][23][24][25][26]. In cycling, there does not appear to be an increased risk of sudden cardiac death in young/middleaged participants with no previous cardiac conditions [27], but in recreational cyclists the occurrence of acute cardiac events increases with age and lower performance level [28]. Cycling is also associated with a risk of acute traumatic injuries [29].…”