Everything that an athlete should keep in mind.

Although it is known that the gyms have the obligation to ask the partners for a physical evaluation that demonstrates a good state of health in order to let trainers know that they are able to perform exercise without risks, many institutions do not comply with it. However, not many people go through a thorough evaluation before signing up for a gym, not to mention that most people do not visit a doctor for a proper check-up, taking into account the impact exercise may have in their joints and muscles.

The best decision is to undergo a series of routine aerobic checks to assess his physical condition due to the usual sports activity he performs in his spare time. And it is well worth the opportunity to remember what a complete check should include and where its importance lies.

Most experts have said that the data of the doctors before a screening test have the main purpose of detecting diseases that can worsen with intense exercise or predispose to a cardiac event, such as sudden death, during sports practise.

These are the aspects a good check-up must take into account:

1.- Cardiological clinical evaluation: includes a questioning about family and personal history with evaluation of eventual risk factors, and detailed physical and cardiovascular examination. This allows obtaining an initial panorama of possible risks to the sport.

2.- Resting electrocardiogram: it allows the detection of electrical alterations, arrhythmias, modifications that suggest the presence of heart diseases, disturbances of the electrical conduction.

3.- Echocardiogram: it allows to analyse the size of the heart (cavities and walls), contraction form, state of the valves.

4.- Ergometry (exercise test) of 12 derivations: consists of making an effort of several protocols, controlling the person with a permanent electrocardiogram and taking the pressure every 2 or 3 minutes. This is done to increase the possibility of obtaining results on the response of the heart when exposed intense effort with possible diagnosis of ischemia, arrhythmias, hypertension to effort.

The indication of the studies depends on the age and the referred antecedents. In young sportsmen, without any kind of symptoms and no antecedents of illnesses, without family antecedents of cardiac diseases, with normal cardiovascular physical examination, the accomplishment of an electrocardiogram of rest may be enough to allow the practise of any sport.

However, in the case of adolescents involved in sports that require high-intensity training, echocardiography is suggested to be carried out periodically. It is also known that in people older than 35 years, or in younger people with risk factors (diabetes, hyperthyroidism, diabetes, hyperthyroidism, hypertension, family history of heart disease in children and adults younger than 55 years old) ergometric tests can be quite useful.

In older people it is necessary to perform deeper studies, at least, in addition to the physical examination and resting electrocardiogram, ergometry, echocardiogram and laboratory tests, which could be repeated annually. Checks prior to sports participation are necessary to prevent sudden death or other cardiac events during physical activity.

Sometimes, to the exercise test it is necessary to add stress images, such as stress echocardiography or gamma camera. According to some experts it is essential to evaluate the performance of athletes and it is possible to directly measure the power and aerobic capacity through the measurement of maximum oxygen consumption (VO2). Those who are more trained require greater consumption of maximum oxygen in the effort.

In conclusion, it could be said that checks prior to sports participation are necessary to prevent sudden death or other cardiac events during physical activity. It is necessary to use the studies we have available, but taking into account their application and frequency according to age, background, findings in the physical examination, results of the first time in the performance, take care of the health of the athlete and avoid elevated costs.

Risks of ignoring pre-training routine check-ups

Before starting any exercise plan it is necessary to review how your health is going on, in order to avoid complications that may even put your life at risk. For this purpose, it is advisable to perform an initial basic laboratory check that includes glycaemia and lipid profile for metabolic assessment and cardiovascular risk.

As part of the necessary tests, a resting electrocardiogram is contemplated and complemented with a specialized cardio logical examination, called eco-stress, which consists of the combination of an echocardiogram with an effort test, so that not only an electrocardiographic record but also images of the effort that the heart makes when subjected to a physical load, which obviously is a programmed and staggered protocol.

The assessment of the athlete must be comprehensive: From the nutritional aspects, musculoskeletal and those tests that can help us assess cardiovascular risk. In addition, the athlete should be made aware that part of their routine should be an annual evaluation of their heart and that whenever there is a change that draws attention, it should reduce the exercise load, since this usually reverses the changes that can put you at risk.

Athletes usually present structural changes called athlete’s heart; which consists of a series of anatomical, electrical and physiological adaptations that cause the heart to increase its size, become thicker and its heart rate lower, which makes it a stronger heart and able to tolerate more time and effort that a person who does not exercise frequently.

There are sports that could involve a greater risk of suffering respiratory or heart disease. The more anaerobic activity required, such as weight lifting; the more likely the heart is to suffer hypertrophy, meaning it gets thicker. However, if the exercise is more aerobic but is high performance, it is related to a higher incidence of sudden death. Sudden death is a form of natural death due to cardiac causes, unexpected in time and in its form of presentation, which is preceded by the sudden loss of consciousness within, at most, the hour following the onset of symptoms, in an individual with known or unknown heart disease.

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