Even Olympic athletes have cardiac abnormalities and may be at risk of CVD

Even athletes whose performance and fitness are at the very highest level may have life-threatening cardiovascular abnormalities. Indeed, a study of more than 2,000 athletes eligible for the summer and winter Olympic games and screened for cardiovascular health has now revealed an unexpectedly high prevalence of cardiovascular conditions, some of which were considered as very serious threats to health.1

"Even Olympic athletes," said Dr Paulo Emilio Adami from the Institute of Sport Medicine and Science of the Italian Olympic Committee in Rome, "regardless of their superior physical performance and astonishing achievements, showed an unexpected large prevalence of cardiovascular abnormalities, including life-threatening conditions."

The study, reported today at EuroPRevent 2015, assessed the cardiovascular health of 2354 elite athletes (1435 male, 919 female, mean age 27.6 years) as part of their screening to compete in Olympic games from 2004 onwards. The screening tests took place between 2002 and 2014. The athletes were engaged in 31 different summer and 15 different winter sports disciplines. Their screening included a physical examination, 12-lead and exercise ECG, and echocardiography. Further tests, which included 24-hour ECG monitoring, were given selectively to confirm earlier diagnoses.

The investigators were surprised to find that 171 of the 2354 athletes screened (7.3%) had some form of cardiovascular abnormality, either structural or electrophysiological (causing a heart rhythm problem).

The abnormality in six of the 171 athletes was considered life-threatening and they were disqualified from competition. The abnormalities detected included cardiomyopathies and coronary heart disease. Hypertrophic cardiomyopathy is one of the most common causes of sudden cardiac death. A further 24 athletes were temporarily suspended but were eventually allowed to take part in the Olympic games under close medical surveillance.

Commenting on the results, Dr Adami said: "It is really surprising that Olympic athletes, who are considered some of the healthiest individuals, should have such significant abnormalities . . . and that despite these abnormalities they had managed to reach such high competitive levels. In most of the cases, their abnormalities had gone unrecognised, because the screenings they had previously had were not as extensive and thorough as the ones we applied.

"We cannot take it for granted that elite athletes are healthy. This study demonstrates that a more accurate assessment is necessary for elite professional athletes than for members of the general population, in view of the intensity and stress on their cardiovascular system through so many hours of training and competition. We suggest that our model of screening is applied to all elite athletes, regardless of the sport they practise."

Dr Adami added that all those wishing to participate in competitive sports should have a medical evaluation, to make sure "that our athletes are competing safely, free from any cardiovascular condition".