Congenital Heart Disease
Cardiac Arrhythmias
Cardiac arrhythmias are disturbabnces in the heart rate or rhythm that result from the dysfunction of orderly depolarization and repolarization of the conduction system that directs contraction and relaxation of the atria.
Atrial Fibrillation: A common abnormal cardiac rhythms in which the atria fail to contract normally. This occurs most in the older population or in those with hyperthyroidism. In AF, the artria quiver instead of contract. AF is treated via drug intervention to slow the heart rate, then to restore a normal heart ryhthm.
Ventricular Fibrillation: Ventricles are unable to contract normally and circulation ceases. VF sometimes occurs following a heart attack. If recognized quickly enough, ryhthm may be resumed by use of an AED. (Crowley, 2014)
Common cardiovascular abnormalities include:
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Patent Ductus Arteriosus
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Patent Foramen Ovale
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Atrial and Ventricular Septal Defects
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Pulmonary or Aortic Valve Stenosis
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Coarctation of the Aorta
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The Terralogy of Fallot
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Transposition of the Great Arteries
The only way to prevent congenital heart disease is to attempt to protect the developing fetus from intrauterine injury during the early phases of pregnancy when the fetus is vulnerable to intrauterine fetal injury. (Crowley, 2014)
Rheumatic heart disease is caused by Rheumatic fever, and is much less frequent now than it used to be. The disease occurs when scarring of the heart valves from healing is present. This causes the valves to close improperly and blood is regurgitated. Valvular dysfunctions may be mild (where no symptoms are seen) to severe (which may cause a heart attack. (Crowley, 2014)
Abnormal development of the semilunar valve leaflets narrows the valve opening. Pulmonary stenosis obstructs outflow from the right ventricle, and aortic stenosis impedes outflow from the left ventricle. Treatment consists of dilating the valve opening by inserting a balloonlike device into the narrow valve opening.
(Crowley, 2014)
Rheumatic Heart Disease
Valve Stenosis
Cardiovascular Dysfunctions
Click the link below to read the NATA position statement on Preventing Sudden death in Athletes
http://www.nata.org/sites/default/files/Preventing-Sudden-Death-Position-Statement_2.pdf
Mitral Valve Prolapse
Endocarditis
Mitral valve prolapse is a common condition from which few people develop symptoms. This occurs when one or both mitral leaflets are enlarged and prolapse into the left atrium during ventricular systole. Sometimes this leads to blood leaking across the closed mitral valve into the atrium. (Crowley, 2014)
Endocarditis is an infection of a heart valve, usually caused by bacteria. Symptoms range from being very minld to severe systematic infection. (Crowley, 2014)
Coronary Heart Disease
Myocardial Infarction
Coronary heart disease occurs due to ateriosclerosis of the large coronary arteries. During ateriosclerosis, the arteries narrow due to the accumulation of fatty materials within the vessel walls. This often leads to an irregular mass of yellow, mushy debris that extends into the muscular and elastic tissue of the arterial wall. Risk factors include: elevated blood lipids, high blood pressure, cigarette smoking and diabetes. Myocardial ischemia often occurs with CHD. Some people may show no symptoms, while others may experience chest pain radiating into the neck or arms. Coronary Artery Disease can be diagnosed through a coronary angiogram. CAD is treated through drugs that improve myocardial oxygen consumption and improve coronary circulation. Persons diagnosed with CAD should also: quit smoking, control hypertension, change their diet to lower cholesterol. attempt to lose weight in a healthy manner, integrate graduated exercises. Surgical interventions are also an option for patients who do not respond to aforementioned action. (Crowley, 2014)
A myocardial infarction is a severe and prolonged myocardial ischemia that precipitates a heart attact in which there is actual necrosis of heart muscle. Mechanisms that trigger a heart attack include: 1. sudden blockage of a coronary artery 2. hemorrhage into an atheromatous plaque 3. arterial spasm 4. sudden greatly increased myocardial oxygen requirement. (Crowley, 2014)
Hypertension
Hypotension
Hypertension occurs when resting blood pressure is approxiamtely 140/90. This mostly occurs from excessive vasoconstriction of arterioles. This causes the heart to pump more forcefully to overcome resistance. Over time, this could lead to cardiac failure. Hypertension accelerates development of atherosclerosis in larger arteries. Severe hypertension may lead to renal failure. Treatment includes reducing blood presure to normal levels through vasodilators. (Crowley, 2014)
Hypotension occurs when resting blood pressure is approxiamtely 90/60. This can lead to symptoms of dizziness, fainting, nausea, blurred vision and in severe cases, can be life-threatening. Causes range from dehydration, to serious medical conditions. Athletes tend to have normal than lower blood pressure, so low blood pressure shouldn't be a concern unless symptoms are common.
Myocarditis
Cardiomyopathy
Myocarditis occurs when there is active inflammation of the heart muscle associated with injury and necrosis of individual muscle fibers, most of the time caused by viruses. Myocarditis may lead to acute heart failure but most of the time, no permanent damage occurs. Treatment consists of bed rest and treating the cause of the inflammation. (Crowley, 2014)
Cardiomyopathy encompasses dilated cardiomyopathy and hypertrophic cardiomyopathy.
Dilated cardiomyopathy: is the enlargement of the heart and dilatation of its chambers, impairing the pumping action, leading to chronic heart failure. There is no known cause or treatment.
Hypertrophic cardiomyopathy: is hereditary and characterized by muscle fibers with no apparent organized pattern and hypertrophy of the heart, leading to dilation dysfunctions in diastole. This leads to inadequate cardiac output. Treatment consists of drugs that slow the heart. (Crowley, 2014)
Thrombosis and Thrombophlebitis
Aneurysms
Venous thromboses occur in leg veins, most commonly. Phlebitis is imflammation of a vein. If there is a thrombosis of the affected vein, thrombophlebitis is used to describe it. DVT, or deep vein thrombosis, often occurs in the leg veins frequently in patients after surgery or those who require extended bed rest. The risk can be minimized by allowing and encouraging patients to exercise or at least participate in active leg movements. (Crowley, 2014)
"An aneurysm is a dilation of the wall of an artery or an outpouching of a portion of the wall." Most occur due to arteriosclerosis, due to the weakening of the vessel wall. The larger the aneurysm, the more likely it is to rupture.
(Crowley, 2014)
Commotio Cordis
Commotio cordis occurs from a traumatic blunt impact to the chest, resulting in cardiac arrest. This condition normally occurs in young, healthy individuals. The cause of the cardiac arrest is that the traumatic blow occurs during a narrow window during the repolarization phase of the cardiac cycle. The reason this occurs in young individuals is due to the pliability of their chest walls.
Signs and symptoms include ventricular fibrillation, left lateral chest trauma, loss of consciousness and in half of cases, immediate death.
Treatment consists of resuscitation (although most often, unsuccessful), and early use of defibrillation with an AED is crucial.
(Prentice, 2011)