Sports cardiology & rehab-Guidelines
Myocarditis, Drugs & Sport, Cardiomyopathies, Rehab-Guidelines
sind ein häufiges Thema, da sie zu einer mehrmonatigen Wettkampfpause zwingen und nicht gar so selten auftreten. Die Vorbeugung derselben ist leider kaum oder nur schwer möglich – Sport bei Fieber sollte aber auf alle Fälle untersagt werden, intensiver Sport bei leichten Infekten ebenso! Bei den Therapien wird die konservative 6-monatige Pause immer mehr überdacht, sodass man sich zu einer 3-monatigen Sportpause hinbewegt – individuell soll man aber immer wenn möglich abklären, aber die generelle Sportabstinenz über mehrere Monate dürfte auch laut Nauen ESC-Guidelines der Vergangenheit angehören. Moderater Sport sei angedacht, Wettkampfsport ist sehr individuell und sollte von Fall zu Fall entschieden werden. Jedoch das generelle Sport- und Bewegungsverbot, das für aktive (Wettkampf)Sportler ja die höchste Strafe per se ist, wurde aber revidiert.
Drugs & sport
Superficial knowledge of doctors and athletes about medication often leads to misinterpretations on their intake. Every athlete or doctor must realise that this lack of knowledge puts them at high risk to fail – no excuses if they do! Alike sport nutrition, ask the experts! Many doctors, therapists or coaches talk about things they do not fully understand and do lack of knowledge but think because they know a little bit about it, that they can handle everything. No they cannot handle everything. Beware of the problem of in-competition and out-of-competition medication, when in-competition starts, how much of something is (not) allowed…!
A huge topic were cardiomyopathies. The different kinds of CMP, their progression, sport and CMP after the diagnosis and the rather new amyloidosis. The talks dealt with mortality, guidelines, risk factors and if patients with CMP are allowed to participate in competitions or not!
Last but not least, the final session was on guidelines for cardiac rehabilitation. The comparison of the DACH-guidelines and the ESC guideline clearly demonstrated huge differences between those four guidelines and the three countries agreed to come up with a similar guideline to allow comparisons because the differences were striking!
The talks by Prim. Dr. Werner Benzer & colleagues reflected that much work is ahead and that changes need to be made – if possible fast! That is not only with respect to the actual therapy time, it’s also when it comes to guidelines per se. Maybe we should think about different guidelines for different age groups, something that is over and over discussed in many rehabilitation centres because it is the daily bread when talking to patients, doctors or therapist colleagues, that there must be a difference between an 40-year-old patient and his guidelines and a 80-year-old patient and his individual guidelines. We always talk about adherence and compliance, with guidelines that more suit the age groups – but still require them to DO something, to STAY active – both, adherence and compliance will increase and that will be good for the patients themselves, their health and finally also for the health system!