State-of-the-Art Paper
Sports and Exercise Cardiology in the United States: Cardiovascular Specialists as Members of the Athlete Healthcare Team

https://doi.org/10.1016/j.jacc.2013.12.033Get rights and content
Under an Elsevier user license
open archive

In recent years, athletic participation has more than doubled in all major demographic groups, while simultaneously, children and adults with established heart disease desire participation in sports and exercise. Despite conferring favorable long-term effects on well-being and survival, exercise can be associated with risk of adverse events in the short term. Complex individual cardiovascular (CV) demands and adaptations imposed by exercise present distinct challenges to the cardiologist asked to evaluate athletes. Here, we describe the evolution of sports and exercise cardiology as a unique discipline within the continuum of CV specialties, provide the rationale for tailoring of CV care to athletes and exercising individuals, define the role of the CV specialist within the athlete care team, and lay the foundation for the development of Sports and Exercise Cardiology in the United States. In 2011, the American College of Cardiology launched the Section of Sports and Exercise Cardiology. Membership has grown from 150 to over 4,000 members in just 2 short years, indicating marked interest from the CV community to advance the integration of sports and exercise cardiology into mainstream CV care. Although the current athlete CV care model has distinct limitations, here, we have outlined a new paradigm of care for the American athlete and exercising individual. By practicing and promoting this new paradigm, we believe we will enhance the CV care of athletes of all ages, and serve the greater athletic community and our nation as a whole, by allowing safest participation in sports and physical activity for all individuals who seek this lifestyle.

Key Words

athlete
cardiology
sports
sudden cardiac arrest
sudden cardiac death

Abbreviations and Acronyms

ACA
anomalous coronary artery
ARVC
arrhythmogenic right ventricular cardiomyopathy
CT
computerized tomography
CV
cardiovascular
echo
echocardiography
EP
electrophysiology
HCM
hypertrophic cardiomyopathy
PPE
pre-participation evaluation
RTP
return-to-play
SCA
sudden cardiac arrest
SCD
sudden cardiac death

Cited by (0)

Dr. Olshansky has served on the data and safety monitoring boards of Boston Scientific, Amarin, and Sanofi-Aventis; has served as a consultant to Boston Scientific, BioControl, Boehringer Ingelheim, Daiichi Sankyo, and Denali Medical; has served as a speaker for Medtronic; and has received honoraria from Boston Scientific, Medtronic, Daiichi Sankyo, Boehringer Ingelheim, BioControl, Amarin, and Sanofi-Aventis. Dr. Daniels receives financial support for research from Actelion, United Therapeutics, Gilead, Bayer, Amplatzer, and the National Institutes of Health. Dr. Sullivan receives financial support from Biotronik for the EPIC Alliance. Dr. Bove has served as a consultant to Insight Telehealth Systems, LLC, and World Health Networks, Inc.; and has stock ownership in Insight Telehealth Systems, LLC. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.