SOMOS Annual meeting
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presents
Wheeless' Textbook of Orthopaedics

Cardiac Sports Conditions:


- See:
      - pulmonary contussion:
      - cardiac enzymes
      - blunt cardiac trauma

- Discussion:
    - defined as cardiogenic shock, arrhythmias requiring treatment, or structural cardiac abnormalities directly related to the cardiac trauma;

- Commotio Cordis:
     - catastrophic condition (rare) that is caused by blunt chest trauma
     - causes cardiac fibrillation and is fatal unless immediate defibrillation is performed;
     - Commotio cordis. Br J Sports Med 2002;36:236-237. 

- Hypertrophic Cardiomyopathy (HCM)
    - may result in deadly conduction abnormalities and is an absolute contraindication to vigorous exercise;
    - causes about 30-50% of sudden-death cases occurring in young athletes;
    - HCM phenotype becomes evident by age 13 to 14 years
    - dectection of heart murmur
            - listen for murmurs in the supine and standing positions to identify murmurs from dynamic left ventricular outflow obstruction (standing intensifies
                    a HCM murmur by decreasing cardiac venous return);
    - cardiac echo:
            - Physiologic limits of LVH in junior athletes: Relevance to diff dx of athlete's heart and hypertrophic cardiomyopathy. J Am College Cardiol 2002;40:1431-1436. 
            - Development and progression of LVH in children with hypertrophic cardiomyopathy. N Engl J Med 1986;315:610-614.

- Long QT Syndrome: (genetic arrhythmia syndrome)
     - characterized by abnormal QT interval on EKG, and can lead to V fib and death;
     - manifests as palpitations (skipped heart beats), presyncope, syncope, and cardiac arrest

- Questions: that every parent should consider

    - Is there any ? syncope (fainting with exertion) , chest pain, shortness of breath with exercise, elevated blood pressure, heart murmur, family history
             or severe early heart disease
Outside Links:
    - Sports Medicine Update (2002)
    - The Preparticipation Athletic Evaluation
    - CPR And External Defibrillator Training May Decrease Adolescent Sports-related Deaths



A prospective evaluation of myocardial contusion: correlation of significant arrhythmias and cardiac output with CPK-MB measurements.
Early detection of myocardial contusion and its complications in patients with blunt trauma.
The utility of cardiac evaluation in the hemodynamically stable patient with suspected myocardial contusion.
A plea for sensible management of myocardial contusion.
Cardiac contusion. The effect on operative management of the patient with trauma injuries;
Sternal fractures: associated injuries and management.
Sternal fractures: a retrospective analysis of 272 cases.
Significance of myocardial contusion following blunt chest trauma.
The clinical significance of myocardial contusion.
Clinically Significant Blunt Cardiac Trauma: Role of Serum Troponin Levels Combined with Electrocardiographic Findings.    Ali Salim, MD et al.  Journal of Trauma 2001;50:237-243


 

Cardiac Abnormalities in the Athlete:
        -
Outcomes in Athletes with Marked ECG Repolarization Abnormalities
        - Long-QT Syndrome
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Preparticipation Exam& Cardiac Risk

 

 

 




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Saturday, January 24, 2009 10:04 am