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Cardiac Concerns: Participation in Sport
Cardiac Concerns: Participation in Sport
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Pdf Summary
The AHA/ACC Scientific Statement highlights hypertrophic cardiomyopathy (HCM) as the leading cause of sudden death among young competitive athletes in the United States. It is identified as a genetic disorder affecting approximately 1 in 500 individuals. The condition is associated with 1500 mutations across 11 major genes impacting cardiac sarcomere, Z disk, and calcium handling proteins. Sudden death in HCM patients is primarily due to ventricular tachyarrhythmias. High-intensity sports exacerbate these risks, making athletic participation a modifiable risk factor.<br /><br />The document outlines strategies for risk stratification, emphasizing that some HCM cases may not present conventional risk markers. It recommends a cautious approach to sports eligibility, balancing the risk of sudden death with the benefits of exercise. The guidelines suggest that athletes with HCM generally avoid competitive sports, except for low-intensity activities.<br /><br />For genotype-positive but phenotype-negative individuals (those carrying the genetic markers without the clinical expression), sports participation is deemed reasonable in the absence of LV hypertrophy and a family history of sudden death.<br /><br />The statement also addresses other cardiomyopathies and myocarditis. Arrhythmogenic right ventricular cardiomyopathy (ARVC) is another focus, particularly prevalent in Italy but less so in the U.S. The guidelines recommend against participation in most competitive sports for individuals diagnosed with ARVC, due to the risk of ventricular arrhythmias and sudden death during exertion.<br /><br />For myocarditis, the document advises against sports participation during active inflammation. An athlete's return to sports requires a normal ECG, absent arrhythmias, and normal ventricular function following a defined recovery period.<br /><br />Overall, the recommendations stress individualized assessment and decisions made in consultation with healthcare providers, considering each athlete's unique health profile and risks. These guidelines aim to mitigate sudden cardiac death risk in athletes with cardiovascular conditions while allowing safe participation in physical activities where possible.
Meta Tag
Edition
2nd Edition
Related Case
2nd Edition, CASE 03
Topic
Cardiac
Keywords
2nd Edition, CASE 03
2nd Edition
Cardiac
hypertrophic cardiomyopathy
sudden death
competitive athletes
genetic disorder
risk stratification
sports eligibility
ventricular tachyarrhythmias
arrhythmogenic right ventricular cardiomyopathy
myocarditis
individualized assessment
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