Kardiovaskuläre Vorsorge im Breitensport, ambitionierten Freizeitsport und Wettkampfsport über das 35. Lebensjahr hinaus

Zusammenfassung

Gerade bei über 30-jährigen ambitionierten Freizeit- und Wettkampfsportlern kommt es immer wieder zu Rhythmusstörungen oder sogar zu plötzlichen Todesfällen. Die Todesfälle während des Marathons, beim Fußball wie auch neuerdings in der Modedisziplin Triathlon, scheinen diesen Berichten Recht zu geben. Die Artikel über das sogenannte Sportlerherz und Komplikationen im Alter beunruhigen die Sportler, Fitness-Fans und Sportmediziner. Es stellt sich die Frage, wie sich Komplikationen durch den ambitionierten Sport im Alter verhindern lassen und wie Freizeit- und ambitionierte Sportler zwischen dem 35. und 75. Lebensjahr zu untersuchen sind. Für Sportler > 35 Jahre sind neben der Anamnese und der körperlichen Untersuchung Basisuntersuchungen mit Ruhe-EKG, Echokardiographie und einem Belastungs-Test (Belastungs-EKG oder Stressechokardiographie) notwendig. Je nach klinischem Bedarf sind zusätzliche Untersuchungen wie Spiroergometrie, Langzeit-EKG oder Kernspinntomographie erforderlich und Carotis-Duplex oder Cardio-CT als Arteriosklerose-Screening möglich. Bei Verdacht auf eine Inflammation kann neben dem Basislabor auch eine Abklärung mit ausgedehntem Labor notwendig werden (inkl. Antikörperdiagnostik) bis hin zu multidisziplinären Untersuchungen (Immunologie/HNO/Neurologie/Zahnmedizin/Kieferorthopädie).

Abstract

Particularly among over 30 years old ambitious hobby- and competitive athletes arrhythmias and even sudden cardiac deaths occur again and again. The spectacular sudden deaths during marathon, football and, just recently, in the trend discipline triathlon seem to support that view. Reports about the “athlete`s heart” and complications in the elderly causes uncertainty among athletes, fitness fans and sports physicians. The question arises, how to avoid complications caused by ambitious sporting activity in the elderly and how to screen hobby- and ambitious athletes between the age of 35 and 75 years. For athletes > 35 years old besides medical history and physical examination basic examinations including resting ECG, echocardiography and exercise ECG/stress echocardiography are mandatory. Further examinations, if clinically necessary, should be spiroergometry, Holter ECG or magnetic resonance tomography and Carotis-Duplex or Cardio-CT for the purpose of arteriosclerosis screening. In suspicious inflammation a further extended laboratory testing may become necessary (incl. viral/bacterial antibodies) or even a multidisciplinary approach (immunological, neurological, dental or orthodontic examination).

Schlüsselwörter

Marathon - Triathlon - Vorsorge Breitensport - Wettkampfsport - körperliche Aktivität

Keywords

marathon - triathlon - pre-participation screening - middle-aged athletes - physical activity

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