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Cardiovascular Assessment in Athletes

Regular exercise has immense benefit on cardiovascular risk and outcomes of patients with cardiac disease. Importantly, exercise has to be regular and if individuals adhere to it, it reduces adverse cardiovascular events by approximately half and prolongs life by 3–7 years, compared to sedentary individuals. On the other hand, intensive exercise may trigger fatal arrhythmias and cause sudden cardiac death, in particular in those prone to it. The incidence of sudden cardiac death in sport is rare and approximates 1 in 50,000, most commonly occurring in males and recreational athletes of 45–50 years old. The causes involved are cardiomyopathies, anomalous coronary origins, and general opathies. Therefore, young athletes, as well as the elderly, taking up exercise should be assessed cardiologically through history, clinical examination, and 12-lead ECG. In elderly individuals, with a cardiovascular history, assessment of cardiovascular risk factors is important as well. Both groups should be encouraged to exercise regularly, unless cardiovascular risk is markedly increased and requires special management.