Nilüfer ÇETİNER, İbrahim Hakan BUCAK, Habip ALMIŞ, Fedli Emre KILIÇ, Mehmet TURGUT

Sporcu Lisansı İçin Başvuran Çocukların Retrospektif Değerlendirilmesi

Amaç: Spor faaliyetlerine katılan çocukların ve ergenlerin sayısı son yıllarda giderek artmaktadır, ancak müsabaka/ antreman sırasında meydana gelen ani ölümler aileler ve toplum arasında endişe kaynağıdır. Bu çalışmanın amacı, çocuklara spor lisansı için pediatrik kardiyolog tarafından değerlendirilmesi gerekir mi sorusuna bir cevap aramaktı.Materyal ve Metod: Yaşları 7-17 arasında olan spora yeni başlamış 168 çocuk çalışmaya dahil edildi. Katılımcılar detaylı bir fizik muayeneden geçirildi ve bir pediatrik kardiyolog tarafından değerlendirildi. Sporcu çocuklar öykü, fizik muayene, 12 derivasyonlu elektrokardiyografi ve ekokardiyografi ile incelendi. Aritmi saptanan hastalar 24 saatlik Holter monitörizasyonu ile araştırıldı.Bulgular: Çalışmada 136 (%81) erkek ve 32 (%19) kız toplam 168 olgu mevcuttu. Olguların yaşları ortalaması 13 yıl (7-17) idi. Tüm katılımcıların % 4,1’inde elektrokardiyogramda ve % 11,9’nda ekokardiyografide patoloji saptandı. Anlamlı şikayeti olan, aritmi saptanan veya aile hikayesi olan 14 çocuğa efor testi, 5 çocuğa 24 saat ritim Holter monitörizasyonu ve hipertansif olan 1 çocuğa 24 saat ambulatuar holter monitörizasyon yapıldı. Holter monitörizasyonu katılımcıların 2’nde sık izole monomorfik ventriküler erken atımı açığa çıkardı. Yedi katılımcı profesyonel spor aktivitelerinden uzaklaştırıldı. Sonuç: Spor aktivitelerine bağlı ani ölümleri engellemek amacı ile spor öncesi kardiyovasküler değerlendirmeyi içeren ulusal kılavuzlar geliştirilmelidir. Genç çocuk sporcuların spor aktivitelerine başlamadan önce bir pediatrik kardiyolog tarafından değerlendirilmesi gerektiği çalışmamızın ana sonucudur.

Anahtar Kelimeler:

ani ölüm, çocuk, elektrokardiyogram, ekokardiyografi, sporcu

Retrospective Evaluation of Children Applying for Athlete Licenses

Objective: The numbers of children and adolescents taking part in sporting activities has risen increasingly in recent years, but sudden deaths occurring during matches or training are a cause for concern among families and in society. The purpose of the study was to seek an answer to the question of whether children should be evaluated by a pediatric cardiologist for sports licenses. Material and Methods: 168 children aged 7-17 who had newly started sporting activities or doing sport for some time were included in the study. Participants underwent a detailed physical examination and were assessed by a pediatric cardiologist. Athletes were examined using history, physical examination, 12-channel echocardiogram and echocardiography. Children with arrhythmia were investigated using 24-h Holter monitoring. Results: 168 cases, 136 (81%) boys and 32 (19%) girls were enrolled. The mean age of the cases was 13 years. Pathology was determined in 4.1% of all subjects at electrocardiogram and in 11.9% at echocardiography. Effort tests were applied to 14 children with significant symptoms, in whom arrhythmia was determined or with a family history, 24-h rhythm Holter monitoring to five children and ambulatory Holter monitoring to one hypertensive child. Holter monitoring revealed frequent isolated monomorphic ventricular premature contraction in two subjects. Seven participants were eventually suspended from sporting activities. Conclusion:National guidelines including presport cardiovascular evaluation have been developed in order to prevent sports-related sudden deaths. The main conclusion from our findings is that young children engaging in sports should be evaluated by a pediatric cardiologist before starting sporting activities.

Keywords:

athletes, child, electrocardiogram, echocardiography, sudden death,

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