Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 2: Preparticipation Screening for Cardiovascular Disease in Competitive Athletes

Maron, Barry J.; Levine, Benjamin D.; Washington, Reginald L.; Baggish, Aaron L.; Kovacs, Richard J.; Maron, Martin S.

doi:10.1161/cir.0000000000000238

Cited by 104 publications

(74 citation statements)

References 43 publications

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“…Reassessment with clinical evaluation and functional testing is indicated before competitive sport participation is resumed. 248,274,275 Nonsteroidal anti-inflammatory drugs should be avoided because of the risk of increased inflammation and mortality. Acute arrhythmia management is supportive, because arrhythmias often resolve with resolution of acute inflammation.…”

Section: Treatment Of Myocarditismentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

603

663

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CLINICAL STATEMENTS AND GUIDELINEST he intent of this American Heart Association (AHA) scientific statement is to summarize our current understanding of dilated cardiomyopathies. There is special emphasis on recent developments in diagnostic approaches and therapies for specific cardiomyopathies. Recommendations in this document are based on published studies, published practice guidelines from the American College of Cardiology (ACC)/AHA 1 and other organizations, 2,3 and the multidisciplinary expertise of the writing group. Existing evidence in epidemiology, classification, diagnosis, and management of specific cardiomyopathies is usually derived from nonrandomized observational studies, registries, case reports, or expert opinion based on clinical experience, not large-scale randomized clinical trials or systematic reviews. Therefore, in this document, rather than using the standard ACC/AHA classification schema of recommendations and level of evidence, 4 we have included key management strategies at the end of each section and categorized our recommendations according to the level of consensus. Although the format of our recommendations might resemble the ACC/AHA classification of recommendations used in the ACC/AHA practice guidelines, because of the preponderance of expert opinion or level of evidence C evidence in our document, we elected to use different terminology to provide a distinction from the practice guidelines, in which stronger levels and quality of evidence with randomized clinical trials or meta-analyses are usually present. 4 The levels of evidence follow the AHA and ACC methods of classifying the level of certainty of the treatment effect. 4 DEfINITIoN of DILATED CArDIoMyopAThyThe term dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders that are characterized by ventricular dilation and depressed myocardial performance in the absence of hypertension, valvular, congenital, or ischemic heart disease. 5 In clinical practice, the pathogenesis of heart failure (HF) has often been placed into 2 categories: ischemic and nonischemic cardiomyopathy. The term nonischemic cardiomyopathy has been interchangeably used with DCM. Although this approach might be practical, it fails to recognize that nonischemic cardiomyopathy can include cardiomyopathies caused by volume or pressure overload (such as hypertension or valvular heart disease) that are not conventionally accepted under the definition of DCM. 1,5 Again, in general practice and clinical research trials, the term ischemic cardiomyopathy is defined as cardiomyopathy caused by ischemic heart disease. Current use of ischemic cardiomyopathy terminology implies ventricular dilation and depressed myocardial contractility caused by ischemia or infarction. CLASSIfICATIoN of CArDIoMyopAThIESThe first classification on this topic categorized cardiomyopathies as heart muscle diseases with dilated (DCM), hypertrophic, restrictive, arrhythmogenic right ventricular (ARVC), or nonclassifiable cardiomyopathy in 1980. 5 Subse...

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Section: Treatment Of Myocarditismentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

603

663

View full text Add to dashboard Cite

show abstract

“…Recently the AHA and the American College of Cardiology (ACC) issued scientific statements concerning preparticipation screening for CV disease in competitive athletes, as well as eligibility and disqualification recommendations for competitive athletes with CV abnormalities, including arrhythmias and conduction defects, cardiac channelopathies, and cardiomyopathies …”

Section: Recommendations For Physical Activity and Exercisementioning

confidence: 99%

“…Recently, the introduction of smartphone technology may further aid real‐time diagnosis of palpitations in the individual or athlete in whom the other tests have not been able to document the arrhythmia . On the other hand, in any young or older individual or patient planning to embark on exercise or athletic activities, preparticipation screening should be performed as detailed earlier in this overview.…”

Section: Strategy For Physical Activity and Exercisementioning

confidence: 99%

Exercise and Arrhythmias: A Double‐Edged Sword

Manolis¹,

Manolis²

2016

Pacing Clinical Electrophis

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Ample evidence indicates that moderate regular exercise is beneficial for both normal individuals and patients with cardiovascular (CV) disease. However, intense and strenuous exercise in individuals with evident or occult underlying CV abnormalities may have adverse effects with provocation and exacerbation of arrhythmias that may lead to life-threatening situations. Both of these aspects of exercise-induced effects are herein reviewed.

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“…In some countries, only anamnesis is performed without the need for ECG, whereas in other countries, ECG is routinely assessed at scans. However, some countries, such as Denmark, do not perform scans during sports because of the low incidence of SCD (13).…”

Section: Introductionmentioning

confidence: 99%

Sudden Cardiac Death in Athletes: Tips for Prevention

Yaman¹,

Akcay²,

Gunay³

2018

Cyprus J Med Sci

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In Turkey, an increase in the number of people interested in running and particularly, in those participating in marathons is quite striking. The age of participants is increasing as well. Nowadays master athletes are often seen in these competitions. Although the benefits of sports are not open to debate, sports events, such as marathons, pose potential risks to participants. Pre-participation evaluations are important as well as follow-ups by a coach for individuals participating in sports to minimize the damage that this paradox can create. Sudden cardiac death (SCD) is the most feared and dramatic situation during organized sports events. Although it is not very common, describing the inflicted trauma is not quite possible. In this review, medical evaluations on adult and elderly athletes, in particular, will be discussed. Coronary artery disease, particularly in this risk group, is the leading cause of SCD. We would like to suggest a three-step evaluation of athletes in this age group. This approach seems to be relatively easy to implement considering its cost effectiveness, and it also helps identifying as many at-risk athletes as possible. Furthermore, we want to emphasize that the regulation of the emergency field of the race environment is very effective in reducing mortality.

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Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 2: Preparticipation Screening for Cardiovascular Disease in Competitive Athletes

Cited by 104 publications

References 43 publications

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Exercise and Arrhythmias: A Double‐Edged Sword

Sudden Cardiac Death in Athletes: Tips for Prevention

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