Pathological "athlete's heart"

Common opinion about the possibility and ways of development of pathological changes of cardiovascular system athlete under the influence of those or other adverse conditions that occur when playing a sport, not yet. However, G. F. lang said that excessive strain as acute single and systematically repeated, cause sooner or later pathological changes in the myocardium, which may develop heart failure and even die.
G. F. lang believed that in the basis of development of these changes lies dystrophic process, the essence of which is the violation of metabolism in the myocardium. These changes are to a certain stage still reversible. With the continuing excessive muscular load such changes become irreversible and are necrosis of muscle fibers. This can lead to sudden death due to utter ventricles, coming in sharp violation of conductivity and excitability on the background of significant biochemical changes of the myocardium. If not, then on the place of necrosis of the muscle fibers, mainly in the left ventricle, is broken scar tissue, i.e. mitostaticski cardiosclerosis. Such changes, limiting the efficiency of the heart, and create conditions for the development of chronic heart failure, the timing of which depends on the patient's behavior. This scheme of development of heart failure, described G. F. lang under physical strain, and today remains in force only as will be seen from further information, to be specified taking into account new scientific evidence.
In addition to the excessive exercise, significant role in the emergence of pathological sports hearts are irrational, unusual load, and the combination of intense physical activity with hard mental work or negative emotions. An important role is played by the presence of chronic infections.
Extremely significant and completely still in force today, is an indication of G. F. lang, that the transition from a physiological "athlete's heart" to pathological and development of heart failure are usually gradually and imperceptibly for the athlete. That is why, as already mentioned, good health, like high functional condition of the sportsman should always be supported by the results of objective examination for the exclusion of pre-pathological and pathological conditions.
It is worth mentioning that the existing division of heart disease organic and functional. This division is very widely used in sports medicine, and it is considered that if the found changes are regarded as functional, the special medical surveillance athlete is not required. However, the presence or absence of a diagnosed by a doctor of morphological changes do not determine the course of the disease, nor its outcome. In the absence of detectable organic changes doctor should not be limited by the fact that some of the identified them changes are functional in nature, and to consider our task on this done. It is still necessary to make a diagnosis, for functional diseases are no less formidable than organic, have a specific and a General designation and require treatment.
According to Mr.. N. Savitsky (1964), division of diseases on a functional and organic are echoes organometallics medicine and deprives disease in their material substrate. After all, the basis of violation of the functions of any organ can lie as gross anatomical changes, and changes at the molecular level. The latter can significantly affect the biological activity of fabric, and discover they cannot often due to the imperfection of modern methods of research. Therefore, in his opinion, the right to divide the disease on reversible and irreversible.
The most striking example confirming the validity of this position is the diagnosis of myocardial dystrophy" (G. F. lang), undoubtedly organic diseases of the heart, which at a certain stage of its development is not revealed existing research methods and reversible. Further development of the degeneration of the heart muscle can lead to irreversible changes. Therefore, we cannot agree with Ya. S. Veinbauma and co-authors (1971), which divide the degeneration of myocardium in physical overload on the functional and organic, functional understanding under reversible, and under organic - irreversible changes. These terms are, of course, cannot be synonymous. In addition, today no one doubts that the degeneration of myocardium always is an organic disease, which is reversible in the early stages of negotiations and irreversible in late.
In sports medicine often, establishing functional character of these or those changes, call it deviations, violations, and so on, not counting necessary to put a specific diagnosis and therefore to treat. However, at each such deviation should be thoroughly understand its Genesis and be sure to make a diagnosis, for all the so-called functional diseases require no less attention than organic. Amorphous the terms "deviations" and so on, divert the attention of a doctor from having clinical analysis of these "deviations" in the health of athletes and frees him from the necessity of their treatment.
The specific symptoms of pathological changes of the heart or circulatory system can be divided into 2 groups. The first is of the diseases of heart and vessels that appear in a healthy person with irrational sport, and above all when excessive physical exertion. These include changes in the myocardium as a result of acute and chronic stress. Hyper - and hypotension state, various violations of heart rhythm, Tonsilla - or hepatomegaly syndrome, and so on, these diseases are considered in this book.
The second group of the diseases of the cardiovascular system, which appear under the influence of sports. This group includes the exacerbation of various heart diseases were the athletes before the beginning of sports and with which they were admitted either because of the disease were not recognized by the doctors, or because the doctor did not give them values and did not consider them as contraindications to exercise. This group includes congenital and acquired heart diseases, hypertension, early coronary atherosclerosis and other
These diseases are, of course, cannot be regarded as a manifestation of pathologic sports heart. However, under the influence of modern sports training they sooner or later will appear, can escalate and often become a cause of disability and even death of the sportsman.
The state of the cardiovascular system, base system, which function limits sports performance athlete, should be subject to careful attention to sports physician, whose task is to correct assessment of the functional state, development of methods of early diagnostics, rational treatment methods and, most importantly, prevention measures.