Sport and heart, the cardiologist: “Italy at the forefront of sports fitness screening”

ROME- How much physical activity is good for the heart? Before approaching a sport, at any age, it is good to submit to a screening of this important organ and what does it consist of? The Dire press agency, on the occasion of the international sports day which takes place today april 6thhe explored this aspect with Dr. Andrea Spampinato, President of the National Association of Cardiology of the Territory and sports doctor (Ance).

Where are we President?

“Italy is a country at the forefront of screening for fitness to practice sports. Athletes must indeed undergo an electrocardiogram, before and after the effort. In subjects under 30 years old, the examination consists of a “step-test”, that is to say that the athlete must go up and down a step for a certain time fixed by the medical protocol.. For athletes over the age of 35-40, it is good practice to perform a “maximal exertion test”. It continues with a cardiological examination and an accurate medical history to look for the possibility of heart disease, family history and whether there have been significant cardiac events in first degree relatives such as arrhythmias and sudden death at an early age. Spirometry is then performed to assess the presence or absence of possible respiratory deficits and finally a urine test; in fact, through it it is possible to highlight a possible kidney disease, although rare, which can occur several times asymptomatically, often congenitally. In these cases, physical activity with high physical exertion is absolutely contraindicated. Whereas in the case of subjects who practice sports at an amateur level, who attend gymnasiums or jog in the open air, it is sufficient to schedule a cardiological visit.with a precise medical history, accompanied by an electrocardiogram making it possible to evaluate or not the presence of a cardiovascular risk”.

The positive implications of sport are known, but can people with heart and vascular problems exercise? If so, what are the most suitable disciplines?

“People who have cardiovascular risk factors can still do physical activity because it is absolutely recommended by international guidelines. Clearly, it must be sewn appropriately, on a case-by-case basis, depending on the heart disease and the patient’s age. Prolonged walking, cycling on the flat, swimming: these are healthy activities since by increasing peripheral capillarization, peripheral resistance decreases, the capacity of the heart pump improves and blood pressure decreases in hypertensive patients. In diabetics, physical activity is good because it lowers blood sugar levels and counteracts weight gain. While patients who have had a cardiovascular event (heart attack or major cardiovascular deficit) physical activity is absolutely recommended. Walking, swimming and other aerobic disciplines are the most appropriate gym activities as they improve functional capacity, prevent relapses, reduce the progression of cardiovascular disease and finally they improve survival”.

We have already touched on the subject but it is perhaps good to dispel another myth and that is that the young and the very young (of school age) cannot get heart disease. What are the risk factors for this age group? What are the tests to check the health of the organ before boys and girls play sports, maybe even high impact?

“Even for them, an electrocardiogram may be enough to uncover these hidden diseases which, in boys, are often asymptomatic and hereditary,” Spampinato points out. “Youn young people can hardly suffer a heart attack due to atherosclerotic degenerative diseases– keep on going- but they can be affected by congenital diseases, genetic pathologieswhere sometimes the first event can be dramatic and fatal. The myth of sudden juvenile death needs to be dispelled as it is very rare. It is really difficult to find those boys who are carriers of an anomaly and who, although they have it, only a small minority of them can go through the dramatic event. This is why secondary prevention may be the right choice: in Italy, automatic life-saving defibrillators are present in sports clubs, on football pitches, now in most gymnasiums, in short, like the fire extinguishers present in every corner of the places where we live that each person can use knowing their simple operation, saving a human life. However, technology today offers us the possibility of diagnosing and treating these pathologies in young people. We can perform non-invasive tests such as echocardiography, magnetic resonance imaging and computed tomography of the heart. The surveys that are to date the ‘Gold standard’ in clinical practice for the study of such pathologies in young people. If these are not enough, more specific diagnostic tests are performed, such as electrophysiological study and electroanatomical mapping of the heart”.

Once heart disease is established, can these boys and girls still engage in motor activity?

“There are some of these genetic pathologies where the risk of an acute event is not triggered by exertion but rather occurs at rest, in the recovery phase or even during sleep. If the specialist identifies this risk in the young athlete, he can resort to various therapeutic aids, both pharmacological and interventional, such as the ablation of the site which triggers the arrhythmias. Therefore, once ‘protected’ from the occurrence of these events, the subjects can continue to practice the sporting activity”.

In conclusion on prevention: how many minutes of sport per week should you practice to “prolong” your life? What should the “typical” heart-saving diet consist of?

“It all depends on age. Many young people practice a competitive sport, characterized by very intense training almost daily, but some recent studies have shown how performing very hard and intense training can be more dangerous than beneficial. So I would say the physical activity must be adequate and based on the characteristics of the subject and on the basis of the age group. People in their 40s and 50s who want to stay in shape should practice at least half an hour of physical activity every other day to prevent cardiovascular disease and increase energy needs, thus avoiding an increase in body weight. In terms of nutrition, I would say that our Mediterranean diet is perfect for sports. It is good to favor vegetable proteins such as legumes and avoid animal proteins. Red meat should not be eaten more than once a week. If the subject is athletic and trains a lot, it will be appropriate to take a good dose of carbohydrates for energy needs.

Often we are not positioned at the top of the world rankings and yet, in this case, Italy is ahead in sports medicine. Is it true?

“Italy is the back in a lot of things but nIn the case of prevention, in the screening of athletes, we are the first country in the world. So much so that our diagnostic protocols, both for the granting of competitive and non-competitive eligibility, are taken as an example and recommended by the various international sports federations as in the case of the United States, Germany and France. “. Professor Spampinato concludes: “Cardiovascular prevention, arrhythmias and many others will be addressed within the framework of National Congress of Ance from June 2 to 4 at the Trevi Autorium of the Pontifical Gregorian University. On Saturday June 3, there will also be a cardiological screening in the region and therefore open to the entire Roman population by appointment”.

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