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sportsmen sportsmen sportsmen bavSvTa sportsmen bavSvTa bavSvTa bavSvTa da da da mozardTa mozardTa mozardTa mozardTa gul gul gul gul gul sisxlZarRvTa gul-sisxlZarRvTa gul gul sisxlZarRvTa sistemis sisxlZarRvTa sisxlZarRvTa

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SLIDE 1

sportsmen sportsmen sportsmen bavSvTa sportsmen bavSvTa bavSvTa bavSvTa da da da mozardTa mozardTa mozardTa mozardTa gul gul gul gul sisxlZarRvTa sisxlZarRvTa sisxlZarRvTa sisxlZarRvTa sistemis sistemis sistemis sistemis gul gul gul gul-sisxlZarRvTa sisxlZarRvTa sisxlZarRvTa sisxlZarRvTa sistemis sistemis sistemis sistemis Tanamedrove Tanamedrove Tanamedrove Tanamedrove marTva arTva marTva marTva prof prof prof. prof. . g.Ca . g.Ca g.CaxunaSvili g.CaxunaSvili xunaSvili xunaSvili

  • med. doqtori n.jobava
  • med. doqtori n.jobava
  • med. doqtori n.jobava
  • med. doqtori n.jobava

03.12.2010

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SLIDE 2
  • janmrTelobis mdgomareobis moSlis,

gadawvrTnisa da gadaZabvis adreuli niSnebis gamovlineba da maTi drouli mkurnaloba

  • bavSvTa da mozardTa

sportuli klubebis bavSvTa da mozardTa sportuli klubebis aRsazrdelTa janmrTelobis mdgomareobis ganmtkiceba da maTi maRali sportuli Sromisunarianobis xangrZlivad SenarCuneba

slide-3
SLIDE 3
slide-4
SLIDE 4

centraluri centraluri nervuli nervuli sistemis sistemis ( (c.n.s c.n.s.) .) gadaZabva gadaZabva gul gul-

  • sisxlZarRvTa

sisxlZarRvTa sistemis sistemis gadaZabva gadaZabva RviZlis RviZlis gadaZabva gadaZabva sayrden sayrden-

  • mamoZravebeli

mamoZravebeli sistemis sistemis gadaZabva gadaZabva

slide-5
SLIDE 5
  • ariTmiebi

ariTmiebi ariTmiebi ariTmiebi

  • QT

QT intervalis intervalis intervalis intervalis gaxangrZliveba axangrZliveba gaxangrZliveba gaxangrZliveba (uecari uecari uecari uecari sikvdili sikvdili sikvdili sikvdili) (uecari uecari uecari uecari sikvdili sikvdili sikvdili sikvdili)

  • korona
  • ronalu

luri ri korona

  • ronalu

luri ri uk ukmarisoba marisoba uk ukmarisoba marisoba k l k lu k l k lu uk uk uk uk

slide-6
SLIDE 6

Conditions that can cause young sudden

Conditions that can cause young sudden

cardiac death

I nform ation on the diagnosis, I nform ation on the diagnosis, I nform ation on the diagnosis, I nform ation on the diagnosis, sym ptom s, genetic sym ptom s, genetic im plications and treatm ent of im plications and treatm ent of im plications and treatm ent of im plications and treatm ent of the follow ing conditions: the follow ing conditions: g

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SLIDE 7

1Hypertrophic Cardiomyopathy (HCM)

  • 2. Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)
  • 3. Dilated Cardiomyopathy (DCM)
  • 4. Myocarditis
  • 5. Coronary Artery Disease (CAD)
  • 6. Ion Channelopathies

Long QT Syndrome B d S d Brugada Syndrome Progressive Cardiac Conduction Defect (Lev-Lenegre’s Syndrome) Idiopathic Ventricular Fibrillation (without Brugada ECG changes) Catecholaminergic Polymorphic VT Catecholaminergic Polymorphic VT

  • 7. Wolff (Wolfe) Parkinson White Syndrome (WPW)
  • 8. Coronary Artery Anomalies (CAAs)

9 Marfan Syndrome

  • 9. Marfan Syndrome
  • 10. Restrictive Cardiomyopathy (RCM)
  • 11. Endocardial Fibroelastosis (EFE)

12 Tachycardia

  • 12. Tachycardia
  • 13. Antibiotic Prophylaxis
  • 14. Churg-Strauss Syndrome
  • 15. Right Bundle Branch Block (RBBB)
  • 15. Right Bundle Branch Block (RBBB)
  • 16. Kawasaki Disease
slide-8
SLIDE 8

The clinical significance of ST The clinical significance of ST-

  • segm ent

segm ent g g deviation and T w ave changes I N CHI LDREN. deviation and T w ave changes I N CHI LDREN. G Ch kh h ili G Ch kh h ili1 N J b N J b

2 K Ch kh

h il K Ch kh h il G.Chakhunashvili G.Chakhunashvili1,N.Jobava ,N.Jobava 2,K.Chakhunashvil ,K.Chakhunashvil i i3. Pediatric Clinic of Tbilisi State Medical Pediatric Clinic of Tbilisi State Medical Pediatric Clinic of Tbilisi State Medical Pediatric Clinic of Tbilisi State Medical University University1, Prophylactic Centre for Mother an Child Prophylactic Centre for Mother an Child2, Treating Treating-

  • Prophylactic Centre

Prophylactic Centre 3, Tbilisi, Georgia. , Tbilisi, Georgia.

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SLIDE 9

J ( J ( Junetion Junetion-

  • SeerTeba

SeerTeba SeerTeba SeerTeba)

slide-10
SLIDE 10

ST ST segmentisa segmentisa segmentisa segmentisa da da da da T T kbilis kbilis kbilis kbilis mor morfologiuri ri mor morfologiuri ri cvl cvlile lebani bani cvl cvlile lebani bani f l g f l g u f l g f l g u cvl cvl le cvl cvl le

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SLIDE 11

cxrili #1

T kbilis maqsimaluri da minimaluri simaRle e.k.g.-s 15 ganxraSi (12 Cveulebrivi da 3 NeHb-is) janmrTel bavSvTa sxvadasxva

ganxra asaki 1 Tve 0-2 weli 3-5 weli 6-10 weli 10-15 weli

asakobriv jgufebSi

maqs. min. maqs. min. maqs. min. maqs. min. maqs. min. I 3

  • 1

4,5 1 5 1,5 5 2 5,5 2 II 6,5 6,5 1,5 7 1,5 5,5 1,5 7 1,5 III 3

  • 1

4,5

  • 2

5 1,5 3 1,5 4,5 1,5 AVR

  • 3
  • 1,5
  • 4,5
  • 3
  • 5
  • 3,5
  • 6
  • 3
  • 5
  • 3

AVL 2,5

  • 2

3

  • 1

3,5

  • 2

4,5

  • 3

4,5 1,5 AVF 3,5 1 3 1 4,5

  • 1

3,5

  • 1,5

5

  • 1

V1 1

  • 6

1

  • 6
  • 1
  • 5,5
  • 1
  • 5
  • 1
  • 5,5

V2 5,5

  • 5,5

3

  • 5

3

  • 3,5

5

  • 5,5

6

  • 7

V3 5

  • 4

3

  • 3

4

  • 4

8

  • 5,5

7

  • 6

V4 5

  • 1

5,5

  • 2

12

  • 1

10 1 11 1 , V5 5 1,5 6 1,5 8 2 9 2,5 10,5 2 V6 6 1 5 2 6 2,5 7,5 2 7,5 2 D 4,25

  • 1,5

3

  • 1

4,25

  • 2,5

5,75

  • 3,5

6

  • 3,5

A 1,75

  • 4

2

  • 3,5

1,25

  • 3,8

1,75

  • 4

1,75

  • 3,5

I 4,25

  • 1,5

3

  • 1

4,25

  • 2,5

5,75

  • 3,5

6

  • 3,5
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SLIDE 12

I cxrilSi mocemulia T kbilis maqsimaluri da minimaluri simaRle e.k.g.-s 15 ganxraSi - 12 I cxrilSi mocemulia T kbilis maqsimaluri da minimaluri simaRle e.k.g. s 15 ganxraSi 12 Cveulebrivi da 3 NeHb-is janmrTel bavSvTa sxvadasxva asakobriv jgufebSi; I cxrilis monacemebi asaxulia 1-5 naxazebSi. T kbilis farTobi ganisazRvreba Semdegi formuliT. S=2/3*a*h, d i i l h i Rl S b i d di bi ##1 16 T kbili sadac a aris sigane, xolo h simaRle. Sesabamisad diagramebi ##1-16 asaxaven T kbilis maqsimalur da minimalur farTs mm2, e.k.g.-s 15 ganxraSi - 12 Cveulebrivi da 3 NeHb-is janmrTel bavSvTa sxvadasxva asakobriv jgufebSi; diagramebi ##1(a)-16(a) asaxavs procentebSi gamosaxul dadebiTi da uaryofiTi T kbilis g ( ) ( ) p g y SemTxvevaTa raodenobebs. II da III cxrilSi mocemulia ST segmentis maqsimaluri cdoma izoeleqtruli xazis zemoT da qvemoT (mm-iT da mm2-iT). ST kbilis farTobi ganisazRvreba Semdegi formuliT. ST QT QRS ST=QT1-QRS SST=ST->xST| diagramebi ##17-30 asaxaven ST segmentis farTs aRniSnul ganxrebSi. cxrilebSi kargad Cans TiToeul ganxrebSi T kbilis maqsimaluri simaRleebi, aseve g g q , minimaluris minimaluri da maqsimaluri simaRleebi. rac Seexeba naxazebsa da diagramebs, isini saSualebas iZlevian bavSvTa asakSi asakis da miuxedavad ganisazRvros depresiuli kbilebis arseboba I standartul ganxraSi - pirveli asakobrivi jgufis garda II standartul ganxraSi yvela asakobriv jgufSi AVF Si da V1 Si pirvel or asakobriv jgufSi jgufis garda. II standartul ganxraSi yvela asakobriv jgufSi AVF-Si da V1-Si pirvel or asakobriv jgufSi. V4-Si bolo 2 asakobriv jgufSi, V5 da V6-Si yvela asakobriv jgufebSi, es ukanaskneli ki warmoadgens dRenaklul bavSvTa kardiologiis wamyvan sadiagnostiko kriteriumebs, romelic mniSvnelovania rogorc daavadebaTa mkurnalobis dasawyisSi, ise misi dinamikis Sesafaseblad - g y , prognozirebisaTvis da rac mTavaria reabilitaciis periodSi gss-s daavadebaTa prevenciisaTvis ukve mozrdilTa asakSi. A

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SLIDE 13

cxrili #2

ST•Ysegmentis maqsimaluri cdoma izoeleqtruli xazis zemoT

mm S (mm2) 1 Tve 0-2 weli 3-5 weli 6-10 weli 10-15 weli 1 Tve 0-2 weli 3-5 weli 6-10 weli 10-15 weli I 1 1 1 1 1 5,05 5,375 4,95 5,875 6,725 II 0,5 0,5 0,5 0,5 0,5 2,525 2,6875 2,475 2,9375 3,3625 III 1 1 1 1 1 5,05 5,375 4,95 5,875 6,725 AVR 0,5 0,5 0,5 0,5 0,5 2,525 2,6875 2,475 2,9375 3,3625 AVL 2 2 2 2 2 10 1 10 75 9 9 11 75 13 45 AVL 2 2 2 2 2 10,1 10,75 9,9 11,75 13,45 AVF 1 1 1 1 1 5,05 5,375 4,95 5,875 6,725 V1 2 2 2 2 2 10,1 10,75 9,9 11,75 13,45 V2 4 4 4 4 4 20,2 21,5 19,8 23,5 26,9 V3 3 3 3 3 3 15,15 16,125 14,85 17,625 20,175 V4 2 2 2 2 2 10,1 10,75 9,9 11,75 13,45 V5 2 2 2 2 2 10,1 10,75 9,9 11,75 13,45 V6 1 1 1 1 1 5,05 5,375 4,95 5,875 6,725 A 1 1 1 1 1 5,05 5,375 4,95 5,875 6,725 D 1 1 1 1 1 5,05 5,375 4,95 5,875 6,725 I 1 1 1 1 1 5,05 5,375 4,95 5,875 6,725

asaki 1 Tve 0-2 weli 3-5 we li 6-10 we li 10- 15 we li li we li QT1saS." 14,6 15,75 16, 9 18, 75 20, 45 ST (mm) 5,05 5,375 4,9 5,8 6,7

  • ST=QT

1-QRS 0 02'' 1

5 75 25 QRSsaS." 4,5 5 7 7 7

1 0,02''=1mm S ST=ST->xST|

slide-14
SLIDE 14

ili #3 cxrili #3

STYsegmentis maqsimaluri cdoma izoeleqtruli xazis qvemoT

mm S(mm2) 1 Tve 0-2 weli 3-5 weli 6-10 weli 10-15 weli 1 Tve 0-2 weli 3-5 weli 6-10 weli 10-15 weli I 0 8 0 8 0 8 0 8 0 8 4 04 4 3 3 96 4 7 5 38 I

  • 0,8
  • 0,8
  • 0,8
  • 0,8
  • 0,8
  • 4,04
  • 4,3
  • 3,96
  • 4,7
  • 5,38

II

  • 0,5
  • 0,5
  • 0,5
  • 0,5
  • 0,5
  • 2,525
  • 2,6875
  • 2,475
  • 2,9375
  • 3,3625

III

  • 1
  • 1
  • 1
  • 1
  • 1
  • 5,05
  • 5,375
  • 4,95
  • 5,875
  • 6,725

AVR

  • 1
  • 1
  • 1
  • 1
  • 1
  • 5,05
  • 5,375
  • 4,95
  • 5,875
  • 6,725

AVL

  • 1
  • 1
  • 1
  • 1
  • 1
  • 5,05
  • 5,375
  • 4,95
  • 5,875
  • 6,725

AVF

  • 1
  • 1
  • 1
  • 1
  • 1
  • 5,05
  • 5,375
  • 4,95
  • 5,875
  • 6,725

V1

  • 2
  • 2
  • 2
  • 2
  • 2
  • 10,1
  • 10,75
  • 9,9
  • 11,75
  • 13,45

V2

  • 3
  • 3
  • 3
  • 3
  • 3
  • 15,15
  • 16,125
  • 14,85
  • 17,625
  • 20,175

V3

  • 3
  • 3
  • 3
  • 3
  • 3
  • 15,15
  • 16,125
  • 14,85
  • 17,625
  • 20,175

V4

  • 2
  • 2
  • 2
  • 2
  • 2
  • 10,1
  • 10,75
  • 9,9
  • 11,75
  • 13,45

V5 V6 A

  • 1
  • 1
  • 1
  • 1
  • 1
  • 5,05
  • 5,375
  • 4,95
  • 5,875
  • 6,725

D

  • 1
  • 1
  • 1
  • 1
  • 1
  • 5 05
  • 5 375
  • 4 95
  • 5 875
  • 6 725

D 1 1 1 1 1 5,05 5,375 4,95 5,875 6,725 I

  • 1
  • 1
  • 1
  • 1
  • 1
  • 5,05
  • 5,375
  • 4,95
  • 5,875
  • 6,725
slide-15
SLIDE 15

8 I 6 8 2 4 2

maqsimumi minimumi

  • 4
  • 2
  • 6

1 Tve 0-2 weli 3-5 weli 6-10 weli 10-15 weli maqsimumi 5.05 5.375 4.95 5.875 6.725 minimumi

  • 4.04
  • 4.3
  • 3.96
  • 4.7
  • 5.38
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SLIDE 16

II 4 2 3 1

  • 2
  • 1

maqsimumi minimumi

4

  • 3

2

  • 4

1 Tve 0-2 weli 3-5 weli 6-10 weli 10-15 weli maqsimumi 2.525 2.6875 2.475 2.9375 3.3625 minimumi 2 2 2 68 2 4 2 93 3 362 minimumi

  • 2.525
  • 2.6875
  • 2.475
  • 2.9375
  • 3.3625
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SLIDE 17

01.06.10.-XXII////-II

Use of BNP in Athlete Heart Pathology Screening Screening

I LI A NADAREI SHVI LI - AI ETI Highest Medical School GEORGE CHAKHUNASHVI LI MD, PhD- TSMU Pediatric Clinic Director Substitute

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SLIDE 18

Cvens mier SemuSavebuli iqnes Cvens mier SemuSavebuli iqnes adaptaci adaptaciuri kardiomiopaTii uri kardiomiopaTiis gamovleni s gamovlenis naadrevi niSnebi, naadrevi niSnebi, romelic mniSvnelovan romelic mniSvnelovan rols rols Seitans Seitans sportsmen portsmen bavSvTa bavSvTa da rols rols Seitans Seitans sportsmen sportsmen bavSvTa bavSvTa da da axalgazrdaTa janmrTelobis axalgazrdaTa janmrTelobis SenarCun SenarCunebaSi ebaSi

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SLIDE 19

0 1 .0 6 .1 0 .TSMU 0 1 .0 6 .1 0 .TSMU-XXI I / I I XXI I / I I 0 1 .0 6 .1 0 .TSMU 0 1 .0 6 .1 0 .TSMU XXI I / I I XXI I / I I

“Production of essential am ino acid rich “Production of essential am ino acid rich natural energetic beverage “ natural energetic beverage “I veriuli I veriuli-

  • Phyto

Phyto” ” g g g g y and its effectiveness in sportsm en” and its effectiveness in sportsm en”

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SLIDE 20

a) kartani b) apikori k t k

slide-21
SLIDE 21

g) apihepati d) apipulmo e t ul

slide-22
SLIDE 22

apiviti apiviti apiviti apiviti apiviti apiviti apiviti apiviti

slide-23
SLIDE 23

sarekomendacio sarekomendacio sarekomendacio sarekomendacio axali axali axali axali modeli modeli modeli modeli sarekomendacio sarekomendacio sarekomendacio sarekomendacio axali axali axali axali modeli modeli modeli modeli

sarTuli “A”

fizioTerapia

fizioTerapevti

“A”

fizioTerapevti masaJisti meTodisti

hipoqsioTerapia

sarTuli “B”

1) Terapiulikonsultacia

pediatri (yoveldRe)

B

ed t (y veldRe) kardiologi (orSabaTi) revmatologi (samSabaTi) Terapevti (oTxSabaTi) endokrinologi (xuTSabaTi) gastroenterologi (paraskevi) imunologi (paraskevi) imunologi (paraskevi)

2) Terapiulikonsultacia

qirurgi (orSabaTi)

  • rToped-travmatologi (samSabaTi)
  • fTalmologi (oTxSabaTi)
  • tolaringologi (xuTSabaTi)

stomatologi (paraskevi)

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SLIDE 24

konsultantTa sabWo k ult t W 3) sportsmenTa sadazRvevo kompania ) 4) laboratoria

konsultant-hematologi (samSabaTi) konsultant-dermatologi (oTxSabaTi)

5) funqciuri diagnostika 5) funqciuri diagnostika

eleqtrokardiografia eqografia kapilaroskopia veloergometria

sarTuli “B”

vel e g et

6) treningTa strategiis SemuSavebis oTaxi

konsultanti _ sportis eqimi konsultanti _ fsiqologiaSi konsultanti _ fsiqiatriaSi konsultanti _ nevrologiaSi konsultanti _ pedagogikaSi konsultanti _ dietologiaSi

slide-25
SLIDE 25

s r u sarTuli “C”

auditoriebi leqciebisaTvis fsiqologTaTvis pedagogikaSi

  • prof. d.uznaZis saxelobis

iakob gogebaSvilis sax.-bis

leqc e v medicinaSi dietologiaSi

  • prof. i.kvaWaZis saxelobis

prof i svaniSvilis sax -bis

sportul medicinaSi

  • prof. i.svaniSvilis sax.-bis

q mwvrTnelTaTvis leqciebi mwvrTnelTaTvis sportsmenTaTvis meTodistebisaTvis medikamentebisaTvis mSoblebisaTvis da a.S.

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SLIDE 26
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SLIDE 27
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SLIDE 28

2010-2011 MEDICAL PACKET same

medi dicino cino pak paketi ti

INSURANCE & PERSONAL INFORMATION FORM sa

sada dazR zRve vevo d da pir piradi in informa rmacia

PERSONAL INFORMATION pe personaluri info rsonaluri informacia cia

Please print all information, except signatures. This form must be signed and completed in order to participate.

Name saxeli, gvari _______ Date of Birth dabadebis TariRi __/___/___Sport ____ S.S. piradi nomeri # __ Nickname zedmetsaxeli__ Marital Status qorwinebis mdgomareoba ____ Local Address ________ City qalaqi _______ State____ Zip ________ L l Ph br n C ll l m b r P t Local Phone adgilobrivi telefoni ______ Cellular mobiluri ____ Permanent mudmivi telefoni ____ Permanent Address mudmivi misamarTi ______ City qalaqi ____ State___ Zip __

PARENT/GUARDIAN INFORMATION i inform

  • rmaci

cia m mSobe

  • belze

ze/m /meurveze rveze

Father/Guardian mama/meurve _____ Mother/Guardian deda/meurve _________ Address misamarTi ____________ Address misamarTi _____________ Home Phonesaxlis telefoni ________ Home Phone saxlis telefoni ________ SS piradi nomeri # ______D.O.B. dabadebis TariRi ____ SS piradi nomeri # ____ D.O.B dabadebis TariRi _____ Employer profesia _____________ Employer profesia ____________ Employer Address samuSaos misamarTi _____ Employer Address samuSaos misamarTi ______ ______ Work Phone samsaxuris nomeri ______ Work Phone samsaxuris nomeri ________

EMERGENCY INFORMATION (In The Event Parents/Guardians Can Not Be Reached) saswrafo i informac macia ( a (im S m SemT mTxv xvev evaSi T Tu mSo mSobel eli/meur urve mi miuw uwvdomel elia)

Name saxeli, gvari__________ Relation to Athlete kavSiri sportTan _______ Address misamarT ______ City qalaqi______ State_____ Zip_______ Home Phone saxlis telefoni _____Work samsaxuri_____ Cellular mobiluri ___

INSURANCE INFORMATION sa sadazR zRve vevo inform vo informacia cia

Primary Insurance (Circle One): ZiriTadi dazRveva: __________________ Insurance Company Name sadazRvevo kompaniis saxeli ___ Phone telefoni ___ Address misamarT________City qalaqi __________State____ Zip_______ Policy # polisi _______________ Group jgufi # _________________ l jguf Deductible Amount gadasaxadi_____________ Date Coverage Begins dafarvis TariRis dasawyisi ______ Termination Date Sewyvetis TariRi _____ Secondary Insurance (Circle One): meoradi dazRveva: __________________ Insurance Company Name sadazRvevo kompaniis saxeli ___ Phone telefoni ___ Address misamarT City qalaqi State Zip ________ y q l q __________ ____ p_______ Policy # polisi _______________ Group jgufi # _________________ Deductible Amount gadasaxadi_____________ Date Coverage Begins dafarvis TariRis dasawyisi ______ Termination Date Sewyvetis TariRi _____

slide-29
SLIDE 29
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SLIDE 30

madlobT madlobT madlobT madlobT