L'efficacia del modello di screening preventivo italiano: dal sopraslivellamento ST durante ergometria alla rivascolarizzazione endomiocardica mediante stent su discendente anteriore

In June 2021, a 40-year-old tennis player came to our Centre of Sports Medicine to renew his agonistic certificate. He did not present any individual or familiar cardiological risk factors. During the ergometric test, at the peak of effort (250 W) he presented an evident and widespread elevation of the ST segment in the precordial area which normalized only after the test's interruption and the change from orthostasis to a reclining position with consequent reduction in heart rate. He reported just a subtle symptomatology of precordial pain, suggestive of unstable angina pectoris. Therefore, the emergency number 112 was called, and the patient was transported to the First Aid. He showed a mobilization of the enzymatic indices of myocardial necrosis (troponin 37 ng/L) and was transferred to the Coronary Unit, where he had a coronary angiography, after only three hours from the maximal ergometric exercise test. It was detected a subocclusive stenosis of the proximal tract of the anterior descending coronary and a stent was applied with subsequent revascularization. the maximal ergometric test with a specific exercise protocol, suitable for each athlete, constitutes a formidable tool for the prevention and stratification of the risk of MI during sport practice.