ΑΘΛΗΤΙΣΜΟΣ και ΥΠΕΡΤΑΣΗ

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1 ΑΘΛΗΤΙΣΜΟΣ και ΥΠΕΡΤΑΣΗ Εύα Καρπάνου Υπερτασικό Ιατρείο ΩΚΚ Ιωάννινα 28/2/2015 Tuesday, March 10, 15

2 ΑΘΛΗΤΙΣΜΟΣ και ΥΠΕΡΤΑΣΗ Εύα Καρπάνου Υπερτασικό Ιατρείο ΩΚΚ Ιωάννινα 28/2/2015 Tuesday, March 10, 15

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4 Hypertension is the most common cardiovascular disease encountered in the athletic population Tuesday, March 10, 15

5 Θέµατα και προβλήµατα Αρτηριακή πίεση και φυσική δραστηριότητα Κλινική προσέγγιση στους υπερτασικούς αθλητές Συσχετίσεις αθληµάτων, υπέρτασης και συνολικού καρδιαγγειακού κινδύνου Tuesday, March 10, 15

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11 BLOOD PRESSURE INCREASES DURING ACUTE STATIC EXERCISE, AND THE INCREASE IS MORE PRONOUNCED THAN WITH DYNAMIC EXERCISE, PARTICULARLY WITH HEAVY STATIC EXERCISE AT AN INTENCITY OF >40-50% OF MΑXIMAL VOLUNTARY CONTRACTION. Fagard Rh. 2011:12: No.37 Tuesday, March 10, 15

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14 Υπέρταση στους αθλητές Κλινική προσέγγιση Tuesday, March 10, 15

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27 Υπερτροφία της αριστερής κοιλίας Tuesday, March 10, 15

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30 Left ventricular hypertrophy* Features distinguishing athletic heart syndrome from Cardiomyopathy Feature Athletic Heart Syndrome Cardiomyopathy Left ventricular enddiastolic diameter < 13 mm > 15 mm < 60 mm > 70 mm Diastolic function Normal (E:A ratio > 1) Abnormal (E:A ratio < 1) Septal hypertrophy Symmetric Asymmetric (in hypertrophic Family history None cardiomyopathy) May be present BP response to exercise Normal Normal or reduced systolic BP response Deconditioning Left ventricular hypertrophy regression No left ventricular hypertrophy regression *A value of 13 to 15 mm is indeterminate. A value of 60 to 70 mm is indeterminate. Tuesday, March 10, 15

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41 Sudden death during sport 1: or 1: student for academic year 1: athlete for academic year 1: jogging for year Tuesday, March 10, 15

42 Sudden death during different sket FootballTrackSoccer Basebal SwimmVolleyhockeyBoxingCrewTennis Wrest Tuesday, March 10, 15

43 CV causes of sudden death in young athletes HCM Coronary artery anomalies Commontio cordis (i.e, blunt chest trauma causing VF) LVH Myocarditis Marfan syndrome Arrythmogenic Right ventricular cardiomyopathy Tunneled coronary artery Dilated CM Aortic Stenosis Myxomatous MV degeneration MVP Drug abuse Long QT syndrome Tuesday, March 10, 15

44 Η στεφανιαία νόσος είναι η κύρια αιτία αιφνιδίου θανάτου στο 75% των αθλητών άνω των 35 ετών Η υπέρταση είναι αναµφίβολα ένας από τους βασικούς παράγοντες κινδύνου στεφανιαίας νόσου Επιπλέον, η υπερτροφία της αριστερής κοιλίας λόγω της υπέρτασης είναι ισχυρότερος παράγοντας κινδύνου ενώ µπορεί να προκαλέσει θανατηφόρες κοιλιακές αρρυθµίες Fagard Rh. 2011:12: No.37 Tuesday, March 10, 15

45 CORONARY ARTERY DISEASE STILL NUMBER ONE Tuesday, March 10, 15

46 THE ADULT ATHLETE

47 THE ADULT ATHLETE CARDIOVASCULAR DISEASE IS THE PRIMARY CAUSE OF DEATH IN ADULT ATHLETES Tuesday, March 10, 15

48 THE ADULT ATHLETE Primary cause: Coronary Artery Disease Cardiomyopathy Vascular Disease Arrhythmia Valvular Heart Disease Tuesday, March 10, 15

49 Who was at greater risk for the development of heart disease? Tuesday, March 10, 15

50 Who was at greater risk for the development of heart disease? Tuesday, March 10, 15

51 Who was at greater risk for the development of heart disease? Jim Fixx - marathon runner, exercise advocate, author Tuesday, March 10, 15

52 Who was at greater risk for the development of heart disease? Jim Fixx - marathon runner, exercise advocate, author Tuesday, March 10, 15 Sir Winston Churchill - broke every tenet of healthy life style

53 Who was at greater risk for the development of heart disease? dead at 53 of a heart attack Jim Fixx - marathon runner, exercise advocate, author Tuesday, March 10, 15 dead at age 91 Sir Winston Churchill - broke every tenet of healthy life style

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58 Ευχαριστώ