¿Jugar o no jugar? El drama de la toma de decisiones en la cardiología deportiva
Palabras clave:
muerte súbita cardíaca, programas de detección diagnóstica, atletas, cardiomiopatía hipertrófica, displasia ventricular derecha arritmogénica.Resumen
Introducción: El deporte competitivo de alto rendimiento está asociado con un aumento del riesgo de muerte súbita cardíaca. La mayoría de los atletas jóvenes que fallecen repentinamente padecen una cardiopatía estructural de base no sospechada. La miocardiopatía hipertrófica y la miocardiopatía arritmogénica ventricular derecha constituyen las dos enfermedades congénitas más comunes relacionadas con este fenómeno.
Objetivos: Revisar las enfermedades más comunes encontradas en los deportistas jóvenes de alto rendimiento, que deben terminar de manera anticipada su carrera deportiva; y evaluar la importancia de la realización oportuna de pruebas precompetitivas para su detección precoz, y el momento para decidir la interrupción de la actividad deportiva competitiva.
Resultados: La identificación temprana de los deportistas afectados en la fase presintomática es posible mediante pruebas de tamizaje precompetitivo. Sin embargo, aún existe un debate acerca de su eficacia, el manejo de los resultados falsos positivos y la rentabilidad de sistematizar estos protocolos.
Conclusiones: Aunque las guías actuales recomiendan retirar de cualquier actividad competitiva a los pacientes con un diagnóstico de miocardiopatía, nuevas evidencias proponen la flexibilización de estos criterios, a partir de la evaluación individualizada de cada atleta.
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