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Up to 80% of athletes who die suddenly had no symptoms or family history of heart disease

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Tips on how to use genetic testing to prevent sudden cardiac death in athletes and allow safe exercise are published today in European Journal of Cardiovascular Disease PreventionThe magazine of a professional skilled uniforms specialist rich skilled skillful specialists of a specialist specialists ).

“Molecular testing for potentially fatal variants is more frequent than ever and this paper focuses on which players should be tested and when, “said author Dr. Michael Papadakis of St George’s, University of London, UK. which may mean isolating or restricting the game. ”

In most cases, clinical evaluation will indicate the need for antibiotics such as defibrillator and advice on exercise and participation in competitive sports. Dr. Papadakis explained, “Even if there is a biological problem, treatment recommendations and return to play usually depend on how severe the disease is in the hospital. Does it cause symptoms such as fainting? Is the heart very weak or and thick? We can see. Most irregular heartbeats (arrhythmias) and they get worse during exercise?

One example is the so-called bed condition hypertrophic cardiomyopathy (HCM), where the heart muscle is very thick, which can lead to sudden cardiac death in athletes. Dr. Papadakis notes, “We used to be conservative but now our decision is more lenient. Athletes with HCM should undergo a full clinical evaluation to assess their risk of coronary heart disease. suddenly and then they are given a license.The genetic test in this case is done. and. how often, for how long, at what intensity, and which exercise or sport is safe. ”

In some cases, however, genetic testing can be ordered and administered. One example is long-term QT ​​(LQTS) syndrome, which is a congenital heart defect. Identifying different types of pathogens (LQT 1-3) can inform the risk of arrhythmias, identify potential triggers for avoidance, and help develop clinical and therapeutic strategies. and plan exercise. Dr. Papadakis says, “For example, sudden drowning in cold water can lead to life-threatening arrhythmias in type 1 QT instead of type 2 or 3, so one should be very careful with those who do. swim that has more than 1 species. runners. ”

The only condition where genetic testing can only result in withdrawal from play is a type of cardiovascular condition called arrhythmogenic cardiomyopathy (ARVC). “Even if an athlete has no clinical evidence of the disease but has a genetic predisposition, he or she should avoid strenuous and competitive sports,” said Dr. Papadakis.2 “This is because research has shown that people with a genetic predisposition who exercise at the right level often become infected early in life and develop a serious illness that can be life-threatening. arrhythmia during games. ”

Antimicrobial testing should be done prior to testing to discuss events for athletes and their families. For example, an athlete’s mother is hospitalized with ARVC and has a viral infection, and the athlete is examined and all clinical tests are normal. The athlete has two options: 1) clinical care, possibly annually, to diagnose symptoms; or 2) genetic testing.

“The athlete needs to know that if the test is positive he can show the end of his career, even if there is no clinical evidence,” said Dr. Papadakis. “On the other hand, if you refuse to take genetic testing, the condition can get worse. , especially if the player is removed from the game. ”

For pediatricians, genetic counseling may be required in a specialist pediatric center with the help of a pediatric mental health professional. Dr. Papadakis points out that, “The psychological impact of positive genetic test results can be significant for a child, especially if this results in a lack of sports or a lack of symptoms such as ARVC.”

In children who have been clinically diagnosed with genital herpes, genetic testing can confirm the diagnosis and in some cases contribute to predicting the risk of sudden death over time. sport. For example, the presence of a gene for cardiac arrhythmias called catecholaminergic polymorphic ventricular tachycardia (CPVT) can lead to recommendations for antibiotics, such as beta blockers, and exercise decisions.

“This is important as CPVT causes heart attacks during exercise and can lead to sudden death from an early age,” says Dr. Papadakis. “By contrast, time genetic testing in children with HCM family history it is controversial since there are no clinical signs and it rarely leads to sudden death in children. ”


The expert described changing the management of heart issues in athletes


Learn more:
European Journal of Cardiovascular Disease Prevention (2022). DOI: 10.1093 / eurjpc / zwac080

hint: Up to 80% of athletes who die suddenly have no symptoms or family history of coronary heart disease (2022, June 16) have been recovered 16 June 2022 from https://medicalxpress.com/ news / 2022-06-athletes-die-die-die-die-alamomin-famili.html

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