Search

Sudden death in athletes is a global problem. Although it is a relatively rare phenomenon (1/100,000 persons), when it does occur, it is often as an incomprehensible event. In fact, it strikes subjects who presumably should be much healthier than the general population. In the previous 20 years, many authors have studied this problem in an attempt to understand the causes and prevent these events, and it has been determined that, in the vast majority of cases, athletes who die suddenly have an underlying heart disease (arrhythmogenic cardiomyopathy, hypertrophic cardiomyopathy, coronary anomalies, channelopathies, etc.).In most cases these diseases do not produce major symptoms and do not preclude sports activity even at the highest levels, although they do increase the incidence of sudden death. How to discover these diseases in asymptomatic athletes is a hotly debated issue. In particular, there is controversy as to whether all athletes should undergo detailed medical screening, including electrocardiogram, or whether the costs of this screening are too high in relation to the event incidence. The purpose of this book is to accurately analyze the causes of sudden death in athletes and to provide cardiologists and sports physicians with useful tips on how to identify at-risk individuals.

Sudden Cardiac Death: Predictors, Prevalence and Clinical Perspectives is a detailed clinical compilation on sudden cardiac death causes. From the various geographical regions of the world comes different clinical perspectives toward the SCD problem that shed light on the predictors and estimated prevalence in genetic inheritance worldwide. For many centuries, the mysterious deaths of prominent professional sportsmen have preoccupied the attention of the media and medical professionals. In some cases, it was possible to obtain the medical histories of the victims, data on the presence of some specific diseases, and conditions or potential symptoms preceding the fatal episode. Various rare inherited syndromes that are associated with congenital heart disease are focused on in this study, and the interrelationship between ventricular premature beats, sustained/non-sustained ventricular tachycardias and ventricular fibrillations are discussed. Cardio-oncology is an emerging field where more and more patients face consequences from radiotherapy and chemotherapy because these individuals become more prone to SCD. Among the most notable developments, three-dimensional echocardiography and myocardial strain imaging are worth noting and might inexpensively improve the current risk stratification process. Recently, a strain that reflects the change of length and thickness of myocardial fibres has been incorporated into the routine clinical practice. The risk of sudden cardiac death is not the same in patients with Chagas disease, and newly predicted factors are to blame. The prevalence of SCD, hypertrophic cardiomyopathy and the accurate risk are extremely challenging, so much so that they recently became a source of argument between European and American experts. This is a must-have book for those interested in a clinical approach to the SCD phenomenon.

Sudden cardiac death is a worldwide pandemic. Over the last years, basic and clinical research has greatly contributed to our understanding of the epidemiology, risk factors, preventive measures and therapy for sudden cardiac death. The advent of the new era of human gene discovering has clarified the genetic basis for inherited arrhythmogenic syndromes potentially leading to sudden cardiac death. Primary prevention measures against coronary artery disease have also translated into a decrease of the incidence of sudden cardiac death in adults, and the advent of implantable defibrillators has been proven to reduce mortality in patients at risk. This book has the aim of providing a concise yet comprehensive update on the major advances in the field of epidemiology, genetics and preventive measures for sudden cardiac death.

Cardiovascular diseases are the most important causes of death in the world today. In adults, the most frequent heart disease is acute myocardial infarction, which can lead to sudden death. To prevent these diseases we need to fight against their main risk factors, which include smoking, lipid disorders, hypertension, diabetes and a sedentary life-style, among others. It has been demonstrated that physical exercise or sports at any age provide notable benefits and can help to decrease other risk factors and reduce the incidence of cardio­ vascular diseases. Exercise can be simply walking or cycling. Aerobic exercise con­ tributes to weight loss and also helps to control blood pressure, cholesterol and diabetes. It therefore plays an important role in prevention of heart diseases. Sports for young people are of great value and advisable not only because they con­ tribute to physical fitness but also because they help in psychological well-being. Young people should be encouraged to include general exercise, and particularly sports, into their daily activities. The following points however, should be kept in mind: I. Although winning at a sport is important, this is only so if it is achieved in natural physical conditions and with the correct training. Therefore, it is advisable to keep well away from any type of activity which artificially increases physical performance, that is, drug taking.

This important issue of Medical Clinics provides essential updates in heart failure. The following topics are covered: epidemiology, pathophysiology, and general approach for heart failure; symptoms, signs, diagnostic studies, and prognostic significance of systolic versus diastolic heart failure; the appropriate use of biomarkers; oral versus intravenous diuretic therapy; guideline-based therapy including RAAS blockade, beta-blockade, and aldosterone antagonist, appropriate use of AICD and biventricular pacing; role of ventricular assist device; pathophysiological consideration and management approaches in acute decompensated heart failure; pathophysiology and current approaches to cardiorenal syndrome; heart failure with other comorbidities including diabetes, obesity, anemia, and cancer; heart failure and atrial fibrillation; and the role of disease management strategies in heart failure.

Clinical cardiologists are encountering an important challenge in the caring of families with inherited cardiac diseases. The majority of the inherited cardiac diseases causing sudden death express themselves at variable ages in the form of altered muscle function (i.e hypertrophic or dilated cardiomyopathy) or in the form of arrhythmias (i.e. Brugada syndrome, long QT syndrome). However, it is not uncommon that the first sign of the disease may actually be sudden cardiac death, even before the identification of clear clinical abnormalities. In this last decade, with more than 50 new disease-associated genes identified, the possibility of genetic testing has opened a new opportunity to disease diagnosis and prevention. Clinical and genetic research is continuously on-going not only to identify those at risk, but to better define their level or risk still with limited success.