Cardiology, exercise and sports
About the book:
The aim of this book is to offer cardiologists, sports medicine specialists and general practitioners, as well as Physical Education teachers, kinesiologists and Sport Science students, the authors’ current knowledge of and professional experience in the cardiovascular system, exercise and sports. This book gives an account of the creation of exercise programs based on the deep knowledge of exercise physiology and training; the effects of an exercise program for the prevention and rehabilitation of cardiovascular diseases; medical examinations that use exercises for the study of individuals who are healthy or have a suspected disease; and diagnostic and evaluation methods indicated for the evaluation of people involved in exercise and sports. We present clinical cases and give suggestions and recommendations for courses of action in cases of athletes with cardiopathies. There are specific chapters about sports in conditions of high altitude, immersion and extreme temperatures, as well as regarding women and children in sports. The final section refers to the general preparation of an athlete in terms of training, nutrition, special qualities and injury prevention.
Thinking about sports cardiology, not just in Argentina but throughout the Spanish-speaking world, necessarily brings us to the figure of Dr. Roberto Peidro. Apart from being a prominent figure of this subspecialty —which in the last three decades has become a differentiated field both in cardiology and in sports medicine—, Dr. Roberto Peidro has the added bonus, among many others, of having been a competitive athlete himself. Surely, his childhood passion for soccer must have always coexisted with his interest —innate in every doctor— in helping others. This led him to spend all his spare time studying Medicine and, later, to specialize in the care of cardiovascular patients who are athletes, as well sports enthusiasts —or non-enthusiasts— of any age and condition.
I was lucky to come across Roberto for the first time in Santiago de Chile in the late nineties. In that first encounter, as well as on later occasions in which we fortunately met on both sides of the Atlantic, I always perceived that ideal combination of qualities that make Roberto Peidro not just a great doctor and cardiologist with a special interest in sports, but also an excellent human being. He has vast knowledge and clinical experience, which he eagerly brings into his day-to-day practice to help athletes and other patients alike. He is also very enthusiastic about sharing his knowledge and experience in conferences, articles and books, not only with simplicity, but also with a great sense of humor that is so typical of him. Last but not least, having been an athlete is a value-added which, the way I see it, is almost indispensable for understanding how an athlete/patient feels, and is of great help when it comes to making complicated decisions.
In today’s society, there is a clear tendency towards a sedentary lifestyle in an ever-increasing number of people, which has a decisive influence in the progression of the obesity pandemic, which in turn results in a prevalence of arterial hypertension and type 2 diabetes. Nowadays, several medical societies are advocating for the practice of regular exercise as one of the essential measures to be taken, both in the prevention and in the treatment of risk factors of cardiovascular disease. This has had a positive impact on society, and in the last two decades the number of people who do exercise and sports has significantly increased. Only a few of them go on to compete at an elite level and have specialized medical attention available. However, both for athletes and for non-athletes who do sports for leisure—the latter being the majority—, the benefits of doing physical activity clearly outweigh the risks. In any case, it is important to keep in mind that in both groups there will be a few who carry some type of cardiovascular disease, and that around one out of three hundred young athletes will be associated with a higher risk of sudden cardiac death. Today we know that many of those individuals not only will not need to give up the exercise they do regularly, but, with the proper medical advice (on the type of activities, the intensity, the frequency, the duration, some special precautions, etc.), they will also be able to keep enjoying and getting the multiple health benefits of doing regular exercise. This also affects professional and non-professional high-level athletes, given that, nowadays, we have a deeper knowledge of the issue, which allows us to certify patients’ physical aptitude for competitive sports in cases of individuals with diseases such as hypertrophic cardiomyopathy or long-QT syndrome, as long as they meet low-risk criteria, pass the required periodic check-ups and follow the recommendations and the prescribed treatment. This is a ray of hope for some of those athletes, whose only choice up until very recently was to stop competing. Nowadays, some of these controversial cases might be resolved with a joint decision after informing the athlete of the risks inherent to their cardiopathy and sport of choice. All this has been made possible thanks to the passion and determination of Dr. Peidro, as well as other important figures of sports cardiology working in different parts of the world over the last three decades. Thanks to all this hard work, today we can detect much more precisely the cardiopathies which are associated with a higher risk of sudden cardiac death during sport activities, or those whose progression might be accelerated due to high-intensity exercise. Not only do we have access to better methods, but also to a greater number of better-prepared professionals. Many of the scientific societies of cardiology and sports medicine from around the world have sections and work groups devoted to sports cardiology. They publish consensus documents that include guides and recommendations which are periodically updated, and even curricular programs (from the European Society of Cardiology and the American College of Cardiology) that deal with the body of knowledge that a sports cardiology specialist should have. There are also some master’s degree courses in Sports Cardiology, and there are even some certification programs for Sports Cardiology centers.
Considering all of the above, it is safe to say that there is a growing interest in sports cardiology around the world, and that this book is responding to a real demand. Taking into account that I have devoted a big part of my life to this field, that I have a high regard and personal admiration for Roberto Peidro, and that the prologue to his first book was written by a figure as prominent as Dr. René Favaloro, I must admit that the possibility of making my contribution with these few lines is a true pleasure and honor to me.
Dr. Luis Serratosa/ Madrid, Spain
Translated by Sofía Yáñez / Edited by Marita Propato