Responses and Adaptation to Exercise Exercise muscles require a large amount of oxygen. Left ventricle mass and volume increase as an adaptive response to aerobic exercise. Signs and Symptoms Chest Pain (angina) Dyspnea Fatigue Palpitations Syncope (fainting) Claudication (limping) Skin and Nail Temperature, Color, Appearance Edema Minimum Components for Preparticipation Physical ExaminationsFamily premature death of a relative living relative younger than 50 years diagnosed with heart disease or other cardiac conditions. Heart murmur Hypertension Unusual Fatigue Exertional Syncope(fatigue) Excessive exertional dyspnea Exertional chest pain Physical Examination Resting Heart rate Blood pressure Auscultation of the heart in supine and standing Assessment of femoral pulses Observation for signs of Marfan Syndrome Hypertrophic Cardiomyopathy Good news: rare Bad news: leading cause of SCD in young athletes Worst news: sudden death is often the first indicator Family history of SCD under 50 or history of insidious syncope, angina, or dyspnea. Managed through medications, activity, restrictions, and surgery. Treatment: medications (B blockers), activity restriction, sometimes surgery. RTP: can only play at low-intensity Intervention: inform athlete and parents the risk of participating in sports Coronary Artery Anomalies (Left main coronary artery abnormally positioned between aortic and pulmonary trunks). Malpositioning Acute angle à impingement No sport Symptoms: may not experience any Coronary Artery Disease (CAD) Valvular Dysfunctions Mitral Valve prolapse Common 5% Uncommon sport SCD Aortic Valve stenosis (narrowing blood flow) Progressive Audible murmur Ruptured Aortic Aneurysm Marfan’s Syndrome S/S: ectomorphic, ocular dysfunction, long appendages, thoracic excavatum, kyphoscoliosis… Static/low dynamic sport Dysrhythmia Wolff-Parkinson-White Syndrome Long QT syndrome Atrial Fibrillation Myocardial Ischemia Occurs when they oxygen needed by the myocardium exceeds the oxygen delivered by the blood in the coronary arteries. Causes chest pain (angina) S&S: fatigue, dyspnea, dizziness and syncope.