[Coronary risk related to sport]

Regular physical activity is beneficial because it is associated with a 40% reduction in the risk of death or myocardial infarction. However, sport momentarily increases the risk of adverse cardiovascular events during the sporting activity. This increased risk is higher in the less accomplished sportsmen and in those with cardiovascular risk factors. Regular weekly exercise, even of mild to moderate intensity, has a protective effect. An adverse coronary event on exercise is observed in 1200 to 1500 patients per year in France. It results from underlying coronary artery disease which is often occult. In the under 35 year age group, although atherosclerotic plaque is already present, the possibility of a congenital anomalous coronary arterial anatomy should be considered. This can sometimes be detected by transoesophageal echocardiography. After 35 years of age, coronary arteriosclerosis is almost the only pathology observed. The probability of a coronary event is higher in under trained "veteran" with known classical cardiovascular risk factors, often occurring by "error" in the practice of an activity too intense for the level of physical fitness. It should be remembered that 50% of these complications occur in people who have experienced symptoms on exercise in the days or weeks before the event. This article also discusses which risk factors aggravate the risk in known coronary patients and what advice should be given to coronary patients who want to benefit from the effects of regular physical exercise.