Athletes with a sick heart. How does sports heart syndrome manifest itself? Possibility of surgical treatment

It's no secret that playing sports affects not only the muscles, but also the internal organs. The heart is the internal organ that sports have the greatest impact on. And this is not surprising, because the heart acts as a pump in the human body, pumping blood into the vascular system. During training, the muscles need oxygen and the heart saturates the muscles with oxygen-enriched blood. In the process of training or other physical activity, the heart works as actively as possible, the heart rate is at a high level in order to provide the muscles with the necessary amount of oxygen. The least active heart works during sleep, when all processes in the human body slow down and the heart rate decreases.

The heart, like muscles, can change under the influence of these loads. The changes in the heart caused by exercise are called sports heart syndrome or simply sports heart.

What is an athletic heart?

sports heart- this is a complex of characteristic changes in the heart, which are of an adaptive nature, which occurred as a result of the systematic performance of a large amount of physical work. The term "athletic heart" first appeared in medical literature in 1899.

The presence of sports heart syndrome cannot be detected without an electrocardiogram, since the sports heart does not have any negative symptoms that could bother a person and does not lead to any health problems.

With the help of echocardiography and electrocardiogram, it can be seen that the sports heart has a large volume of chambers and a thicker wall of the myocardium. Such changes in the heart can be interpreted as eccentric hypertrophy (typical for representatives of those sports in which endurance is predominantly trained) or concentric hypertrophy (typical for representatives of those sports in which strength is predominantly trained).

How does the functionality of a sports heart change?

Since the sports heart has larger chambers and thicker myocardial walls, it is stronger and more productive, and therefore can pump more blood per beat than the average person's heart. The consequence of this is that the athlete's heart needs to make fewer contractions in order to provide the body with oxygen. That is why one of the symptoms of a sports heart is a low heart rate - 50-60 beats per minute. At the same time, in some professional athletes, the heart rate can drop to 30 beats per minute.

Under what conditions does sports heart syndrome develop?

As mentioned above, sports heart syndrome develops when a person systematically performs a large amount of physical work. At the moment, doctors agree that for the development of sports heart syndrome, it is enough to train for about seven hours a week. One study found that endurance athletes were more likely to develop sports heart syndrome. It was also found that in such athletes, both the left and right ventricles increase. In athletes who develop strength, as a rule, only the left ventricle increases.

How do I know if I have Athletic Heart Syndrome?

In order to find out if you have sports heart syndrome, you need to see a cardiologist who will prescribe an echocardiogram and an electrocardiogram.

Should I be concerned if the change has sports heart syndrome?

In general, you should not worry about a sports heart, because despite changes in the structure, the work of the heart in sports heart syndrome is not disturbed. However, it is worth visiting a cardiologist periodically to monitor the condition of the heart.

It is also worth noting that after a person stops exercising, their heart shrinks and within a year or two ceases to be athletic.

Physical activity helps to strengthen the heart, has a beneficial effect on its work and endurance. Moreover, it is hypodynamia - the lack of adequate physical activity - that is one of the risk factors for the development of diseases of the heart and blood vessels. At the same time, everyone is well aware that professional athletes are frequent patients of cardiologists. How, in fact, sport changes the heart and where is the acceptable line, the MedAboutMe portal understood.

Benefits of sports for heart health

The heart pumps blood around the body, which, in particular, delivers the necessary oxygen to organs and tissues. In the event that the myocardium does not work enough, the body may experience hypoxia - a dangerous condition not only for its symptoms (shortness of breath, weakness, etc.), but posing a direct threat to human health and life. Patients with heart failure find it difficult to withstand even minimal physical activity, such as climbing stairs. At some point, they can cause collapse - a critical drop in blood pressure with a possible fatal outcome.

Sport allows you to avoid such dangerous conditions. With any physical activity, the muscles' need for oxygen increases, which means that the heart begins to work harder to be able to pump more blood. Thus, the myocardium trains, gets used to possible increased loads and quickly returns to normal operation after them. A trained person is not afraid of even sudden loads, because his heart is able to quickly rebuild (change the rhythm) without any damage.

In addition, an increase in the intensity of the work of the heart activates metabolic processes, and this allows the myocardium, blood vessels and blood itself to recover and renew itself more easily. In particular, the content of "bad" cholesterol in the blood decreases, which causes atherosclerosis - the main cause of coronary heart disease with subsequent myocardial infarction.

Despite all the benefits of physical activity for the cardiovascular system, sports can still become a prerequisite for serious disorders in the work of the heart. And this is due to how exactly the myocardium changes, responding to constant loads.

Most often, athletes are diagnosed with the following conditions:

Dilatation of the left atrium - an increase in the volume of the chamber of the heart.

Due to the fact that the myocardium during training is forced to pump large volumes of blood, the muscle begins not only to contract more intensively, but also to stretch, because in this way it can capture a larger volume of blood at a time. The dilatation can be corrected if the athlete reduces the intensity of their training. However, if the left atrium is stretched for a long time, fibrous tissue degeneration occurs. Firstly, the myocardium can no longer completely relax, which affects its work. Secondly, the stretched parts of the heart stop pumping blood efficiently. As a result, heart failure develops, which can lead to cardiac arrest.

Hypertrophic cardiomyopathy is a change and thickening of the walls of the left (rarely right) ventricle of the heart.

Although the causes of the development of the disease have not been identified to the end, nevertheless, such a pathology is often diagnosed precisely in intensively training people. Moreover, this diagnosis is the most common cause of sudden death from cardiac arrest in young athletes during training.

Bradycardia is a decrease in heart rate.

Normally, in a healthy person, the pulse is 60-80 beats per minute. If the heart contracts less than 60 times per minute, this, against the background of other CVS diseases, can lead to a serious deterioration in health and even disability. But if the heart is constantly receiving loads, which means it begins to pump blood more efficiently in one contraction, at rest the pulse of a healthy person can be 35-40 beats per minute. Therefore, cardiologists single out the bradycardia of athletes - a condition that is the norm and does not affect health. Moreover, such bradycardia makes the work of the heart more economical.

Fitness hypotension (low blood pressure) is an adaptive response to constant physical activity.

A decrease in blood pressure is associated with an increased load on the vessels due to increased blood flow. The arteries of a trained person are larger in diameter, which means that at rest, with an average need for oxygen, the blood will pass through them with less intensity - the pressure will be lowered. In addition, during training, systems aimed at lowering blood pressure are activated in the body. This mechanism can be considered compensatory - physical activity increases the need for oxygen, puts a strain on the heart and thereby increases blood pressure. And the body compensates for these jumps with a response. Training hypotension is 32.2% of all hypotensions in athletes.

Why can sports affect the work of the heart in such different ways? Why in some cases does it prolong its work, while in others it leads to the development of pathologies? The main reason for this different influence is the choice of training intensity. And it is easiest to calculate it by increasing the heart rate (HR), because it depends on this, with what force the blood is pumped.

In order to calculate the allowable milestones, you can use the following scheme: a number equal to the number of full years is subtracted from 220. The resulting value is the maximum heart rate (MHR). Workouts are divided into:

Warm-up, load for people with CCC diseases - 50-60% of the maximum.
Aerobic exercise, acceptable training for a healthy person who wants to support the heart - 60-75%.
Anaerobic load, training, which can lead to myocardial pathologies - 75-90%.
Dangerous load, risk of death - 90-100%.

It should be understood that such calculations are very individual, and depend on other factors. For example, for a trained athlete whose heart is used to enduring heavy loads, even the maximum heart rate for a short time may not be dangerous. But for hypertensive patients, classes in “safe” values of aerobic exercise can cause a significant deterioration in the condition.

There are a number of factors to consider when choosing the intensity of your workout. If they are, it is better to give preference to smaller loads.

Excess weight.

Excess body weight in itself puts an increased workload on the heart, since it must supply more tissues with blood. In the event that the myocardium is not trained, but is under such a load, intense fitness can harm the heart.

Diseases of the cardiovascular system.

The danger is that many of them are asymptomatic in the early stages - a person is not even aware of their presence. Therefore, before signing up for sports, it is necessary to undergo a cardiological examination.

Smoking, alcohol, fatty foods, overeating.

All this gives an increased load on the heart, so it is better to give up bad habits - they are incompatible with sports.

Stress.

Emotional stress, like physical stress, increases the heart rate. Therefore, in this state, it is best to start training with relaxing exercises, and move on to intense ones only after the pulse normalizes.

If increased loads for untrained muscles end in krepatura (delayed muscle pain syndrome), then the heart may respond with various malfunctions - heart rhythm disturbances, increased pressure, and so on.

Therefore, for training the heart, the systematic loads are more important, and not their maximum possible intensity. For a healthy person, training 3-4 times a week is suitable if an aerobic load (60-75% of the MHR) is selected, and with a minimum load (less than 60% of the MHR), you can practice daily.

The removal of the athlete from training until the complete normalization of the ECG is shown. Sanitation of foci of chronic infection is necessary.

In the treatment of dystrophic changes, their genesis must be taken into account.

In case of excessive exposure to catecholamines on the myocardium, the use of beta-blockers is recommended, and in case of insufficient catecholamine exposure, levodopa (the precursor of catecholamines) is recommended.

The appointment of drugs that improve myocardial metabolism is also shown: Ritmokor, Cardioton, ATP-LONG, ATP-forte, Potassium orotate, Folic acid, Calcium pangamate, anabolic steroids, Cocarboxylase, multivitamins, pyridoxal phosphate, vitamin B12, Riboxin, carnitine preparations.

Preventive pharmacotherapy of the early stages of chronic physical overexertion of the heart involves the use of agents that, by their action, can be regarded as activating the synthesis of nucleic acids and proteins, normalizing electrolyte balance, and having an adrenolytic effect. However, their purpose should be differentiated depending on the presence of the predominant factor - dilatation and / or hypertrophy, since this implies an impact on the main pathogenetic mechanism of the “sports” heart manifestations - systolic and / or diastolic myocardial function.

In the case of the predominance of myocardial hypertrophy, assessed by the mass of the left ventricular myocardium and the myocardial mass index, over dilatation, the use of metabolic drugs that enhance plastic processes in the myocardium should be limited, since at the stage of pathological “sports” heart, hypertrophy development may increase. In this case, drugs with an energizing effect are shown that enhance the formation of ATP and creatine phosphate, which are necessary to enhance both systole and diastole. For this purpose, preparations of adenosine triphosphoric acid and its coordination compounds are recommended, providing a more stable effect - ATP-LONG, ATP-forte, Egon. The mechanism of action of these drugs is based on the effect on the purinergic receptors of the heart, which leads to the limitation of calcium "overload" of myocytes, vasodilatation of the coronary arteries, reduction of afterload and economization of the activity of the heart. In addition, coordination complexes are less susceptible to deamination by adenosine deaminase, which provides a prolonged effect, unlike adenosine triphosphoric acid. Metabolic products ATP-LONG, ATP-forte are able to activate de novo intracellular ATP synthesis through the stage of formation of purine bases.

The action of creatine phosphate (Neoton) is based on the suppression of the activity of 5-nucleotidase, which leads to a decrease in the breakdown of ATP in cells, especially in erythrocytes. Creatine phosphate preparations, through de novo synthesis, increase the pool of intracellular creatine phosphate, contributing to an increase in myocardial contractile activity. More attractive from this point of view are chelate compounds of creatine phosphate with magnesium ions (Reaton), which ensures a higher efficiency of the drug, since in the form of a chelate complex it is less susceptible to destruction and can be used in the form of tablets containing 0.5 g of the active substance. Reaton is the first tableted chelate complex of creatine phosphate.

To enhance energy processes in the myocardium, the appointment of lipoic acid, which is involved in the synthesis of acetyl coenzyme A, is shown, which reduces the amount of lactate produced and increases the formation of pyruvic acid, which is an active energy substrate. An increase in energy production and a decrease in the accumulation of lactate in myocardiocytes are inherent in cocarboxylate and especially its chelate form with magnesium ions - Alakton. The drugs act on an alternative energy pathway in myocytes by activating the transketolase reaction of the pentose phosphate shunt for glucose oxidation.

Another drug that directly affects the reaction of the pentose phosphate shunt is Ritmocor. Ritmokor contains gluconic acid in the form of magnesium and potassium salts. The bioavailability of the drug is about 95%, which avoids the side effects of magnesium on the gastrointestinal tract, since the absorption of other magnesium preparations from the gastrointestinal tract does not exceed 40%. Gluconic acid stimulates the pentose phosphate pathway of glucose oxidation in the myocardium, increasing energy production in the myocardium and skeletal muscles and helps to reduce the severity of clinical and ECG manifestations of the "sports" heart syndrome, and also significantly improves physical performance. Rhythmocor also has an antiarrhythmic effect, which makes it possible to consider it as a means of pathogenetic therapy for mitral valve prolapse.

It should be noted that magnesium in the form of a salt of gluconic acid is found in the Cardioton preparation, which also contains folic acid and hawthorn extract (vitexin glycoside). The latter has a moderate cardiotonic activity, which differs in its mechanism of action from cardiac glycosides, which allows the use of Cardioton in mitral valve prolapse, including in "athletic" heart. Vitexin, which is part of cardiotonus, realizes its action through an increase in the adaptive Frank-Starling mechanism, and not through an increase in calcium ions in myocardiocytes, which favorably distinguishes it from cardiac glycosides, which are contraindicated in case of diastolic dysfunction in a “sports” heart.

To enhance energy processes, the appointment of L-carnitine preparations is indicated. By improving the utilization of fatty acids, carnitine reduces the effects of energy deficiency by stimulating the formation of ATP in mitochondria. In addition, carnitine preparations can increase the ejection fraction without affecting the development of myocardial hypertrophy. Carnitine can also reduce the effects of acidosis.

Justified with a "sports" heart and the appointment of drugs containing respiratory enzymes - cytochrome C (Cytomak) and Coenzyme Q10 Compositum. The drugs improve tissue respiration by affecting the transport of electrons in the respiratory chain of mitochondria, and enhance oxidative phosphorylation.

With severe hypertrophy and the development of systolic myocardial dysfunction and concomitant cardiac arrhythmias, as well as in individuals with sympathicotonia, the appointment of beta-blockers is indicated. Their appointment is contraindicated in bradycardia (heart rate less than 55 beats / min); if necessary, the selection of doses should be carried out titrated and take into account the fact that beta-blockers are included in the list of drugs prohibited by WADA.

With a dilated form of a "sports" heart, in addition to drugs of energy action, the appointment of drugs that affect the plastic exchange of the myocardium can be justified.

It is generally accepted to prescribe Methyluracil in combination with folic acid and vitamin B12. Another regimen includes potassium orotate, cocarboxylase, and vitamin B15. In the presence of cardiac arrhythmia, Ritmokor or Panangin are added to the above schemes. Perhaps the appointment of anabolic steroids. By enhancing protein biosynthesis, they are able to increase the mass of the myocardium, normalizing the ratio of the mass of the ventricular myocardium to the size of the cavities. The drugs have a different androgenic-anabolic index, which should be taken into account when using them. Drugs are contraindicated in adolescence. It should be remembered that anabolic steroids are classified as doping drugs, so their appointment should be strictly justified and only for therapeutic purposes!

For the prevention of chronic overstrain syndrome in athletes, it is also proposed to use various schemes for the use of multivitamins (Seifulla, 1999). There are also known attempts to develop methods for the prevention of chronic overstrain syndrome in young athletes using plant-derived adaptogens (Polisol-2, Antihypoxin), physical rehabilitation methods, as well as the use of antioxidants (ascorbic acid, Tocopherol acetate, Methionine) (Polyakov, 1994; Azizov, 1997; Aidaeva, 1998).

The effectiveness of therapy with magnesium preparations has been shown for manifestations of disadaptation to physical activity, while the use of magnesium orotate helps to increase physical performance in athletes (Jalalov, 2000; Bogoslav, 2001).

Preparations containing magnesium (Magne-forte, Ritmokor, Magne-B6, Magnerot) are most justified in the presence of tonogenic dilatation. Natural antagonists of calcium ions, they help to reduce the “calcium” overload of myocytes, thereby improving the diastolic function (relaxation) of the myocardium, which leads to the activation of the Frank-Starling mechanism and an increase in contractile function. In the case of severe diastolic dysfunction, it is possible to use dihydropyridine calcium channel blockers (Amlodipine, Lacidipine). However, their pronounced hemodynamic (lowering blood pressure) effect should be taken into account. Therefore, it is better to give preference to magnesium-containing drugs. In addition, some drugs have a pronounced antiarrhythmic effect (Rhythmocor, Magnerot), which allows them to prescribe cardiac arrhythmias. These drugs do not affect the heart rate, so they can be prescribed for bradycardia.

With tonogenic dilatation, it is possible to use drugs that inhibit the carnitine-dependent mechanism of fatty acid oxidation - Trimetazidine, Ranolazine. However, their application should be of a course nature. It should be remembered that with a hypertrophic form of the "sports" heart, their use is inappropriate.

In recent years, the homeopathic method has been increasingly used to prevent and eliminate the consequences of the negative effects on the body of intensive sports. This method has no scientific basis. Homeopathic remedies in clinical trials have shown themselves to be completely ineffective. And the people who use them, as a rule, are victims of charlatans.

It should be noted that cardiac pathology can also appear in adolescent athletes. Young athletes with a pathological "athletic" heart should be under the constant supervision of a cardiorheumatologist.

In addition, Quercetin, Lipin, Glycine, Tanakan, etc. are used.

Of great importance in preventing the development of a pathological "athletic" heart is the correct training regimen.

Important is the scientific substantiation of sports training regimens in childhood, adolescence and youth (Khrushchev, 1991).

This also applies to the physical health program. The threshold value of the intensity of the load, providing a minimum healing effect, is considered to be work at the level of 50% of the IPC or 65% of the maximum age-related heart rate (corresponding to a pulse of about 120 beats/min for beginners and 130 beats/min for trained runners). Training at a heart rate below the indicated values is ineffective for the development of endurance, since the stroke volume of blood in this case does not reach its maximum value and the heart does not fully use its reserve capabilities.

Metabolic drugs in pediatric practice (S.S. Kazak, 2006)

Name	Doses and routes of administration
Actovegin (Solcoseryl)	Inside 1 dragee three times a day or 2-5 ml in / in a stream or drip in 100 ml of isotonic sodium chloride solution every other day -10 days
ATP-LONG	60-80 mg per day
Inosine (Riboxin)	Inside 1-2 tab. (200-400 mg) three times a day for 4-6 weeks or 5-10 ml of a 2% solution i.v. bolus or drip once a day, 10-14 days
Potassium orotate	20 mg/kg per day by mouth in three divided doses
Lipoic acid	Inside, 1-2 tablets. Two to three times a day
Magnesium Orotate	Inside 1 tab. (500 mg) twice daily for 6 weeks
Magne-V 6	Inside 1 tab. or 1/2 ampoules (5 ml) twice a day
Mega-L-carnitine	Inside, 1 ml (0.5 g of carnitine) once or twice a day
Mildronate	Inside, 1 cap. (250 mg) once or twice a day for 2-3 weeks or 1.0-2.5-5.0 ml parenterally (50 mg / kg) of a 10% solution per day, course 5-10 days
Neoton (phosphocreatinine)	1-2 g IV drip in 200 ml of 5% glucose solution once or twice a day. Heading dose 5-8 g
	Inside 10-20 mg / kg three times a day for 2-3 weeks or 2-5 ml IV slowly or drip in 5-10% glucose solution
Preducgal (Trimetazidine)	Inside 1/2 tab. (20 mg) three times a day
Cytochrome C	0.5 mg / kg per day (4-8 ml of a 0.25% solution) intravenously in 200 ml of a 5% glucose solution once a day
Carnitine chloride	20% solution up to 6 years -14 drops, after 6 years - from 25 to 40 drops two to three times a day for 3-4 weeks
Phosfaden	1 mg / kg up to 6 years twice a day, after 6 years - three times a day or 2% solution 25 mg / kg per day / m two to three times a day for 10-14 days
Ritmocore	Capsules 0.36 g, children over 6 years By 1 cape. Twice a day, over 12 years old - 1 cap, three times a day

Consequently, the range of safe loads that have a training effect in recreational physical education, depending on age and fitness level, can vary from 120 to 150 bpm. Training with a higher heart rate in recreational running cannot be considered expedient, since it has a clear sports focus. This is confirmed by the recommendations of the American Institute of Sports Medicine (AISM).

When choosing training loads for young athletes, one should take into account the peculiarities of their hemodynamics. So, according to I.T. Korneeva et al. (2003), at rest in young athletes with a normokinetic type of blood circulation, the chronoinotropic mechanism practically does not participate in ensuring cardiac output, and athletes with this type of blood circulation should be considered as insufficiently adapted to perform endurance work. For young athletes with a hyperkinetic type of blood circulation, volumetric, low-intensity loads should be recommended, and for young athletes with a normokinetic type of blood circulation, an increase in the volume of loads in a gentle-increasing mode.

The problem of the physiological and pathological "sports" heart remains relevant and in modern conditions is conditioned by increasing physical and psycho-emotional stress in sports, the most acute struggle during competitions, and a high level of sports achievements. A properly developed training process under medical supervision with adequate pharmacological support makes it possible to prevent the development of a pathological “sports” heart and maintain the health of athletes.

Regular intense physical activity leads to an increase in the cavities of the myocardium and its thickening. The sports heart contracts less often, but stronger, this ensures sufficient nutrition of muscle tissue and internal organs, and the expedient expenditure of energy resources. With overtraining, myocardial diseases occur.

Read in this article

What is the difference between the heart of an athlete and an ordinary person

The heart of a person who systematically goes in for sports becomes more efficient, while the mode of its functioning switches to a more economical use of energy. This is possible due to three features - an increase in size, an increase in the strength of contractions and a slowdown in the pulse.

Overall volume

In order to be able to provide all organs with a sufficient supply of oxygen during high physical exertion, the heart must pump a larger volume of blood. Therefore, athletes increase the total capacity of the heart chambers due to expansion ().

Also, an excessive change in the heart is explained by thickening of the myocardium (), mainly in the walls of the ventricles. These features help to ensure the main advantage of a sports heart - greater performance.

On the left is a healthy heart, and on the right is an athlete's heart

The size of the heart depends on the type of activity. The highest rates were observed in skiers, as well as in cycling or long-distance running. The heart increases slightly less during endurance training. With power types of loads, dilatation should not be, or it is quite insignificant, the total volume of the heart chambers should not differ significantly from the indicators of ordinary people.

For example, there are several indicators of radiography from a distance (teleroentgenography), which is used to measurements of heart volume in cm3:

men aged 25, untrained - 750;
young women with low physical activity - 560;
athletes of high-speed sports - up to 1000, cases of increase to 1800 are known.

Comparison of ultrasound of the heart of an ordinary person and an athlete-athlete

Rhythm

The most consistent sign of a well-trained athlete is a slow heart rate at rest. It has been proven that bradycardia occurs more often during endurance training, and in male masters of sports, the pulse drops to 45 or less beats per minute. This is regarded as a mechanism for switching to a more economical way of working, since slow rhythm provides:

decrease in the need of the heart muscle for oxygen;
an increase in the duration of diastole;
restoration of wasted energy reserves;
increased nutrition of hypertrophied myocardium (due to vasoconstriction during systole, blood flow in the coronary vessels decreases).

The reason for slowing down the heart rate is a change in the parameters of the activity of the autonomic regulation of the heart - the tone of the parasympathetic department increases, and the sympathetic influences weaken. This is made possible by intense physical work.

Stroke volume

In healthy people who are not involved in sports, the release of blood into the vessels is 40 - 85 ml per contraction. In athletes, it rises to 100, and in some cases up to 140 ml at rest. This is explained both by a larger body area (higher height and weight), for example, in basketball players, weightlifters, and with the nature of the loads. The highest rates of stroke volume are among skiers, cyclists, and swimmers.

Short and thin athletes involved in low-intensity sports have performance that is only slightly different from other people. There is also no direct effect of sports on such an indicator as the heart index. It is calculated by dividing the shock output per minute by the total body area.

Heart and speed or endurance training

The strength of contractions of the heart muscle obeys the Frank-Starling law: the more the muscle fibers are stretched, the more intense the compression of the ventricles. This is true not only for the myocardium, but also for all smooth and striated muscles.

The mechanism of this action can be represented by pulling the bow string - the more it is pulled out, the stronger the launch will be. This increase in cardiomyocytes cannot be unlimited, if the increase in the length of the fibers is more than 35 - 38%, then the myocardium weakens. The second way to enhance the work of the heart is to increase the blood pressure in its chambers. In response, the muscle layer thickens to counteract hypertension.

All loads are divided into dynamic and static. They have a fundamentally different effect on the myocardium. The first type of training involves the development of endurance. This is primarily important for runners, skaters, cyclists, swimmers. The following adaptation processes take place in the body:

Thus, in athletes with a predominance of dynamic (aerobic) load, dilatation (expansion) of the cardiac cavities is observed with a minimum degree of myocardial hypertrophy.

Isometric loads (power) do not change the length of muscle fibers, but increase their tone. Tense muscles compress the arteries, increasing the resistance of their walls.

With this type of training, the need for oxygen is moderate, but there is no increase in blood flow through the compressed arteries, so tissue nutrition is provided by increasing blood pressure. Constant hypertension during exercise provokes myocardial hypertrophy without expansion of the cavities.

Watch the video about what happens to the heart during exercise:

Diseases of athletes

All adaptive reactions increase athletic performance only under physiological training regimes. When playing professional sports, there is often a breakdown of adaptive mechanisms, when the heart cannot withstand overload. Similar pathological phenomena occur in situations where artificial stimulants - energy and anabolics - are used for success in competitions.

Bradycardia

A decrease in heart rate is not always proof of good fitness. In about a third of athletes, a low pulse is accompanied by such manifestations:

performance decreases;
the increase in loads is poorly tolerated;
sleep is disturbed;
appetite drops;
there is periodic and darkening in the eyes;
difficulty breathing;
there is a pressing pain in the chest;
concentration decreases.

Such complaints often accompany overwork or infectious processes. Therefore, when the heart rate drops to 40 or less beats per minute, it is necessary to conduct an examination of the heart and internal organs to identify possible pathological changes.

Hypertrophy

The formation of a thickened muscle layer is associated with a constant increase in the level of pressure inside the heart. This triggers an increased formation of contractile proteins, the mass of the heart increases. In the future, it is hypertrophy that becomes the only way to adapt to increased sports loads. The consequences of an increase in muscle volume are manifested in the form of such changes:

the myocardium is weakly restored during diastole;
the size of the atria increases;
increased excitability of the heart muscle;
disruption of impulse conduction.

All these factors provoke the development of various arrhythmias and systemic circulatory disorders, the appearance of pain syndrome. With intense exertion, shortness of breath and a feeling of interruptions, dizziness, and chest pain occur. In severe cases, suffocation increases, which is a manifestation of cardiac asthma or pulmonary edema.

Arrhythmia

In violation of the heart rhythm, a significant place is given to the physiological increase in the tone of the parasympathetic nervous system, which is noted during intensive sports. This provokes a slowdown in the conduction of impulses in the atrioventricular node, up to.

Prolonged endurance exercise can cause atrial fibrillation, attacks of supraventricular and ventricular tachycardia. The clinical significance of arrhythmia increases many times in the presence of congenital abnormalities in the structure and functioning of the conduction system of the heart. For example, the presence of Wolff-Parkinson-White syndromes or a prolonged QT interval can be the cause of sudden death.

Arterial hypotension

Increased parasympathetic tone leads to a decrease not only in the pulse rate, but also in the resistance of the peripheral arteries, so the blood pressure in athletes is lower than in untrained peers. At the same time, the majority do not feel it, since during the period of exertion, blood circulation is activated - the minute and stroke volume of blood ejection increases. If the compensatory mechanisms weaken, then changes in hemodynamics are not enough.

Deterioration of well-being can be associated with an infection, an allergic reaction, trauma, dehydration. In such cases, there is a fainting state, short-term loss of vision, pale skin, unsteadiness when walking, nausea. Severe cases can cause loss of consciousness.

Changes in children

If a child begins to train intensively at preschool age, then due to the incomplete process of formation of the cardiovascular and nervous system, adaptive reactions are violated. It has been proven that after 7-10 months from the start of sports activities in a child of 5-7 years old, the thickness of the myocardium and the mass of muscle tissue in the left ventricle increase, but its stretching does not occur. In this case, the absence of an increase in the stroke volume of the heart is essential.

Hypertrophy of the heart muscle without dilatation of the cavities occurs due to high sympathetic tone and sensitivity of the heart to the action of stress hormones. This can explain the greater degree of myocardial tension and uneconomical energy consumption.

Children are recommended more frequent monitoring of all hemodynamic parameters than in the group of adult athletes, nutrition with sufficient protein and vitamins, as well as gentle training with a gradual increase in intensity before the competition.

It is contraindicated to play sports for children in the presence of:

chronic diseases of internal organs;
foci of infection in the upper respiratory tract, teeth;
heart defects;
, including transferred;
arrhythmias;
congenital conduction disorders;
neurocirculatory dystonia, especially with increased activity of the sympathetic nervous system.

What is special in the heart of a former athlete

Muscular tissue of the heart, as well as skeletal muscles, after the cessation of stress tends to return to its original state, losing the ability to function actively. After a month break, the heart begins to decrease in size. At the same time, the speed of such a process depends on the previous stage of loads - the longer the athlete was engaged, the slower he loses shape.

A particular danger threatens those people who are forced or deliberately abruptly stop training. This primarily leads to violations of autonomic influences on the heart. Manifestations can be in the form of discomfort, shortness of breath, congestion in the limbs, rhythm disturbances, up to serious arrhythmias with circulatory failure.

Preparations and vitamins for the myocardium

Athletes do not need specific treatment if they do not have:

chest pain;
interruptions in the work of the heart;
increased fatigue;
fainting states;
ECG changes - ischemia, arrhythmia, conduction disturbance.

In such cases, changes in the heart are considered physiological, to strengthen the myocardium, the following drugs can be used:

if myocardial hypertrophy predominates - ATP-forte, Neoton, Espa-lipon, Cytochrome, with increased pressure and tachycardia, beta-blockers are prescribed -,;
with a predominant expansion of the cavities of the heart - Magne B6, Ritmokor, Methyluracil with folic acid, Potassium orotate, vitamin B12;

vitamins - special multicomponent complexes for athletes (Optimen, Optivumen, Multipro, Supermulti), vitamin and mineral preparations (Supradin, Farmaton, Oligovit);
adaptogens - tincture of leuzea, rhodiola, hawthorn;
nutritional supplements - Omega 3, Ubiquinone, Succinic acid.

If there are significant violations of the heart, then these funds are not enough. With the development of the syndrome of pathological sports heart, complex treatment is carried out using antihypertensive, antiarrhythmic drugs, cardiotonic drugs.

Adaptation of the cardiovascular system to sports activities depends on the specifics of training. With aerobic exercise, the expansion of the chambers of the heart predominates, and with power - thickening of the myocardium. At the same time, physiological parasympathicotonia causes slowing of the rhythm, hypotension and reduced conduction of cardiac impulses in all athletes.

If there are complaints about the work of the heart, it is necessary to undergo a complete examination, since overtraining can lead to diseases. To increase resistance to physical activity, drugs are used, taking into account the type of sport and the results of diagnostics.

Useful video

Watch the video lecture on running and the heart:

Signs of a sports heart

Increased physical activity increases the number of heartbeats. With constant exercise, the heart becomes more efficient and switches to economical energy consumption, while the heart rate (HR) does not increase much. This happens due to the fact that the organ increases in size, the pulse slows down and the force of contraction increases.

Often in athletes there is a breakdown of the adaptive mechanism, in which the heart does not tolerate a large load. A person has the following symptoms:

Bradycardia. It is characterized by sleep disturbance, poor appetite, shortness of breath. A person may experience pressing pain in the chest, concentration of attention decreases. He does not tolerate stress, periodically dizzy. Often such complaints are associated with infections present in the body. When the pulse drops to 40 beats, an examination of the organs should be carried out.
Hypertrophy. A constant increase in intracardiac pressure causes an increase in the muscle layer. It manifests itself in the form of an increase in the size of the atria, a violation of the conduction of impulses, an increase in the excitability of the heart muscle. The athlete experiences dizziness, pain in the chest, shortness of breath.
Arrhythmia. At high loads, a physiological increase in the tone of the parasympathetic system is noted. This condition causes various pathologies of the heart: ventricular extrasystole, atrial fibrillation, tachycardia. The athlete may experience chest pain, palpitations, and shortness of breath. He has a state of fainting.
Hypotension. Athletes have lower blood pressure levels than normal people. This happens due to reduced resistance of the peripheral arteries and is often accompanied by bradycardia and a decreased pulse. Hypotension can cause a breakdown, headache and dizziness.

A person may not notice these changes, but soon there are complaints of dizziness, reduced performance. He begins to tire quickly, he is worried about fatigue. Over time, other pathologies develop, electrical instability of the tissue occurs, which leads to death.

Sudden cardiac arrest can occur against the background of an improperly designed workout, a sharp increase in load, stress and depression, and classes after an illness. Provoking factors are hereditary predisposition and the use of doping drugs.

The heart makes itself felt in the former champions. A person who has stopped exercising is subjected to disruption of autonomic influences on the heart. This condition manifests itself in the form of a violation of the heart rhythm, shortness of breath, discomfort and congestion in the arms and legs.

Sometimes sports heart syndrome occurs in children. In young men, the vascular network is not as well developed as in men. Their body is not always ready for an ever-increasing load. Vessels do not keep pace with increasing myocardial hypertrophy. This causes various heart pathologies in a child whose parents sent them to big-time sports.

Types of sports heart

The sports heart is of two types:

Physiological.
This type is characterized by the following indicators: pulse no more than 60 beats per minute, moderately severe sinus arrhythmia, bradycardia at rest. The physiological sports heart is able to increase the amount of blood per minute by increasing the stroke volume.
Pathological.
This type involves a change in the heart under the influence of physical overstrain. In this case, the organ is subjected to an excessive load, which exceeds the reserve capabilities of a person. At the same time, the athlete has an increase in the volume of the heart by a factor of two, pronounced tachycardia.

In order to timely identify pathological changes in the work of the body, it is important to regularly undergo examinations using modern diagnostic methods.

Measures to identify pathology

In case of complaints about the work of the heart, it is necessary to undergo examinations and consult a doctor. Diagnosis includes echocardiography, ECG and stress testing. Additionally, 24-hour Holter ECG monitoring or stress echocardiography is used. It is impossible to diagnose sports heart syndrome on your own.

Often, signs of pathology are detected during examination of other organs or during routine screening. It is important to be able to distinguish this syndrome from disorders caused by similar manifestations and posing a threat to life, for example, ischemic disease.

Treatment

Specific therapy is not required if there are no:

pain sensations;
fainting;
ischemia;
arrhythmia;
increased fatigue;
conduction disturbance.

In this case, the changes are considered physiological. As a preventive measure, you can prescribe:

Beta blockers.
Adaptogens.
Vitamin and mineral complexes.
Nutritional supplements.

In case of serious violations of cardiac work, complex treatment is carried out with the use of cardiotonic, antihypertensive and antiarrhythmic drugs.

Proper nutrition plays an important role, especially for young athletes. The menu should contain a sufficient amount of protein, be rational and quite high-calorie. Eat foods rich in vitamins and minerals.

The diet must include the following foods:

cottage cheese;
vegetables;
fruits;
fish;
meat;
juices.

In advanced cases, surgical intervention and a complete rejection of sports loads are indicated, sometimes a pacemaker is required.

Contraindications to sports activities

There is a list of diseases that prevent admission to sports. These include the following heart conditions:

Defect (congenital and acquired).
Rheumatic diseases.
Hypertension.
Ischemic disease.

Children are contraindicated in sports in the following cases:

infections of the teeth and ENT organs;
arrhythmia;
valve prolapse;
myocarditis;
heart disease;
chronic pathologies of internal organs;
cardiopsychoneurosis;
VSD with a crisis course;
age up to 6 years.

The health of athletes must be monitored by doctors. Their work includes the following activities.