Abstract des Autors

The most frequent cardiovascular accident in athletes, older than 35, is the ischemic cardiopathy. Therefore, at the Sport's Medicine Institute in Rome, athletes who have passed this age have to undergo not only the normal step test and clinical visit (D.M. 18/2/1982), but also a maximal effort test (ergometric cycle or treadmill). Starting from September 1994 until September 1997, 505 athletes have undergone the maximal effort test; they had to use gradually heavier weights, proportionally to the level of exercise. The exercise lasted, except particular situations, until exhaustion. In most tests the results were fortunately negative. Only in a few cases there were found: arrhythmias (a slightly higher percentage than with the step test), a slight pressure increase in subjects with normal resting pressure and ventricular repolarization anomalies, suggesting ischemic cardiopathy. Of the 8 athletes with tests suggesting ischemia, 7 were absolutely asymptomatic and three were athletes of a discrete level. Only five continued the medical examinations and were found positive to the coronary scintigraphy; one had to be operated. The step test never identified alterations that could suggest an ischemic cardiopathy; it was possible to suspect it only after the maximal effort test. Even though "positive" subjects are only very rarely found, we think that the maximal effort test should always be used to grant an agonistic certificate to people above the age of 50, considering the legal responsibility doctors specialized in Sport's Medicine in Italy have. Verf.-Referat