Sports Cardiology

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Sports Cardiology

Introduction

Aspetar’s Sports Cardiology department provides clinical services for professional and recreational athletes including routine evaluations and cardiac screenings intended to identify pre-existing cardiovascular abnormalities and thereby reducing the potential for adverse events and loss of life.

 

Athletes are known for their extraordinary fitness levels and pursuit of achieving their best potential. Unfortunately, a small yet notable proportion of athletes have suffered from what is called sudden cardiac death (SCD) during sports participation. Approximately 80% of non-traumatic sudden deaths in athletes below 35 years of age are attributed to several hereditary or congenital heart disorders that predispose them to malignant ventricular arrhythmias. While still a minimal percentage, the frequency with which SCD is prevalent in young athletes has called for the implementation of organised screening programmes by most major sporting governing bodies, including the International Olympic Committee (IOC) and the Fédération Internationale de Football Association (FIFA).

To date the Aspetar Sports Cardiology team have performed cardiovascular screenings in more than 15000 athletes, a number of which are currently undergoing regular follow ups for cardiac conditions in Aspetar, to ensure they remain training and competing safely, while a minority of cases were found to have cardiovascular conditions associated with SCD which management required advice against competitive sports.

 

Aspetar offers the following Sports Cardiology services:

  • Complete cardiac evaluation aims to identify underlying cardiac conditions predisposing to SCD
  • Cardiology follow up for athletes with cardiac abnormalities while they remain involved in competitive or recreational sports
  • Evaluation of symptoms such as syncope, chest pain, palpitations, or shortness of breath that occur during training or competition
  • Evaluation of an unexplained deterioration in athletic performance or impaired athletic performance due to previous medical condition/treatment
  • Athletes education, lifestyle recommendations and exercise advice including competitive sports eligibility for those with cardiovascular risk factors or cardiac abnormalities
  • Training and safety guidelines with special interest in the development and implementation of cardiac emergency action plan for sports venue and competitive sports events

 

Aspetar’s Sports Cardiology team consists of specialized cardiologist trained in the care and management of athletes, exercise and cardiac physiologists, and other specialists that provide support for the evaluation and treatment of athletes with heart cconditions.

The goal is to keep athletes active in sports by providing timely and comprehensive individual and sport specific cardiovascular assessments and individualized recommendations for sports participation. We aim to offer treatments that will allow athletes to continue to play sports safely.

During the cardiology evaluation the doctors focus on identifying potentially serious cardiovascular conditions that, if left untreated, could harm the athlete. When the risk of a major adverse cardiac event during competitive sport is significantly elevated a shared decision is made regarding competitive activities together with the athlete and third parties if required (Clubs and Federations), taking into account medical guidelines, evidence base and expert recommendations in the best interest of the athletes.

 

Despite the success achieved since testing has been implemented, one of the main challenges of the cardiovascular assessment in athletes is still the interpretation of the electrical and structural heart modifications observed in the ECG and echocardiography of the athletes as a result of the long term training, the so called ‘athlete’s heart’; the features of which occasionally overlap with cardiac disorders commonly implicated in sudden cardiac death.

Based on the phenomenal awareness that the Sports Cardiology department has garnered thus far, Aspetar has produced over 60 articles in peer-reviewed scientific journals, including two British Journal of Sports Medicine special issues on ‘Sports Cardiology’, outlining how to assist physicians in lowering the risk of mistakenly interpreting ECG and echocardiography changes in athletes, thereby limiting the number of unnecessary sporting disqualifications. These changes differ between ethnicities, and Aspetar, through the Sports Cardiology department, is the world leader in understanding the impact of the West Asian ethnicity (covering the Gulf, Middle East, Maghreb, Persia and East Asia) upon the cardiovascular adaptations induced by regular and intensive exercise. Our research has also contributed to a better understanding of the athletic remodelling of athletes from African ethnicity.

Working with athletes of all ages, and thanks to the unique structure of Aspire Academy which athletes are under the care of the Aspetar Cardiology team, we have studied and published an important body of knowledge on the development of the athlete’s heart in young paediatric population from age 12 to adulthood, contributing to a better understanding of how young athlete’s cardiovascular system matures and which are the normal range of cardiac parameters according to the athlete’s maturation.

In cooperation with national and international organizations and sports governing bodies, the Aspetar Sports Cardiology team have contributed to the education in Sports Cardiology providing lectures in a number of international events, organizing international activities and creating the first Clinical Specialist Fellowship in Sports Cardiology program in the Gulf region.

 

The protection of the health of the Athletes is one of the pillars of Sports and Exercise Medicine. At Aspetar, the Sports Cardiology programme is dedicated to the basic principles of enabling the safe participation of athletes in their chosen sport and of injury and illness prevention. Aspetar Sports Cardiology is integrated with other aspects of daily clinical practice as part of our mission to “assist athletes to achieve their maximum performance and full potential”.