The sudden death of an athlete is a highly tragic and emotional event. Recent data suggest that death rates are greater than previously reported and a screening strategy with the 12–lead electrocardiogram (ECG) may help identify those athletes at risk. One of the main concerns about cardiac testing in athletes is the high number of false positive rates because athletic conditioning is associated with a number of electrical and structural modifications which occasionally overlap with disorders commonly implicated in sudden cardiac death.
For the practicing sports medicine physician at the front line of sports cardiology, this comprehensive and authoritative resource provides a centralized source of information which addresses this important topic in an accessible manner. This book recognises the broad role sports physicians play, from liaison between athlete, family, specialist, and coaching staff based on the identification of pathological heart disease, to being first to respond when an athlete collapses. The chapters include basic science of disease and disorders, pathophysiology, diagnosis, the effect or role of exercise, and clinical management guidance.
The seven sections of this book include information on: the basic science of cardiac function, the prevention of sudden death, specific cardiac disorders predisposing individuals to sudden cardiac death, management and screening of athletes, and the provision of emergency care.
This book:
Provides a comprehensive and authoritative overview on all aspects of sports cardiology
Addresses cardiac abnormalities confronting Olympic athletes, Paralympic athletes, as well as athletes competing on all other levels of competition
Endorsed by the Medical Commission of the International Olympic Committee (IOC)
Written and edited by global thought leaders in sports medicine
An essential resource for sports medicine physicians, cardiologists, sports cardiologists, primary care physicians, ER physicians, physical therapists, athletic trainers, nurse practitioners, and physician′s assistants.
Table of Contents
Contributors, x
Foreword, xiii
Preface, xiv
PART 1 The Cardiovascular System 1
1 Anatomy and Physiology of the Heart 3
Keith P. George and Nathan Riding
2 The Vascular System 13
N. Tim Cable
3 Energy Production Pathways During Exercise 21
Sébastien Racinais and Stéphane Perrey
4 Cardiovascular Responses to Exercise 32
Julien D. Périard
5 The Athlete s Heart: Impact of Age, Sex, Ethnicity and Sporting Discipline 43
Tracey Keteepe ]Arachi and Nabeel Sheikh
6 Physical Activity in the Prevention and Management of Atherosclerotic Disease 53
John P. Buckley
PART 2 Preventing Sudden Cardiac Death in Athletes 63
7 Incidence and Aetiology of Sudden Cardiac Death in Athletes 65
Kimberly G. Harmon
8 Cardiovascular Screening for the Prevention of Sudden Cardiac Death in Athletes 74
Antonio Pelliccia and Domenico Corrado
9 Comparison of Pre ]participation Evaluations for Assessing Cardiovascular Risk in Athletes 82
Ramy S. Abdelfattah and Mathew G. Wilson
10 Normal Electrocardiographic Findings in Athletes 95
Mathew G. Wilson and Victoria Watt
11 Abnormal Electrocardiographic Findings in Athletes: Recognising Changes Suggestive of Cardiomyopathy 104
Gherardo Finocchiaro and Michael Papadakis
12 Abnormal Electrocardiographic Findings in Athletes: Recognising Changes Suggestive of Primary Electrical Disease 114
Jordan Prutkin
13 Effective Echocardiographic Assessment of the Athlete: Basic Examination to Advanced Imaging Techniques 128
David Oxborough
14 Early Repolarisation in Athletes 147
Greg Mellor and Elijah R. Behr
15 Clinical (Laboratory) Exercise Testing 153
Jonathan Myers and Victor Froelicher
16 The Role of Cardiovascular Magnetic Resonance in the Assessment of Athletes 163
Rory O Hanlon
17 Genetic Testing for Cardiovascular Conditions Predisposing to Sudden Death 175
Colleen Caleshu and Euan Ashley
PART 3 Cardiac Conditions Predisposing to Sudden Cardiac Death 187
Section 1: Introduction 189
18 Causes of Sudden Cardiac Death in Sport: The Importance of Autopsy and Specialist Examination of the Heart 191
Mary N. Sheppard
Section 2: Inherited and Congenital Cardiovascular Pathologies 203
19 Hypertrophic Cardiomyopathy 205
David S. Owens
20 Arrhythmogenic Right Ventricular Cardiomyopathy 217
Alessandro Zorzi and Domenico Corrado
21 Dilated Cardiomyopathy, Left Ventricular Hypertrabeculation and Noncompaction 231
Sabiha Gati and Sanjay Sharma
22 Marfan Syndrome and Aortopathies 240
Anne H. Child and Bethan Davies
23 Valvular Disease 247
Kathleen E. Kearney and Catherine M. Otto
24 Congenital Heart Disease 263
Guido E. Pieles and A. Graham Stuart
25 Congenital Coronary Artery Anomalies 275
Cristina Basso and Gaetano Thiene
Section 3: Ion Channelopathies, Accessory Pathways and Electrical Disease 287
26 Long QT Syndrome 289
David J. Tester and Michael J. Ackerman
27 Brugada Syndrome 303
Elena Arbelo and Josep Brugada
28 Wolff Parkinson White Syndrome 315
Jack C. Salerno
29 Catecholaminergic Polymorphic Ventricular Tachycardia 324
Leonie C.H. Wong and Elijah R. Behr
30 Idiopathic Ventricular Tachycardia/Ventricular Fibrillation 331
André La Gerche
Section 4: Acquired Disorders 341
31 Commotio Cordis 343
Christopher Madias and Mark S. Link
32 Myocarditis 350
Jeffrey A. Towbin
Section 5: Other Causes of Sudden Death 359
33 Alternative Noncardiac Medical Causes of Sudden Death: Sickle ]Cell Trait, Exertional Heatstroke, Exercise Rhabdomyolysis, Asthma and Extreme Environmental Conditions 361
Juan Manuel Alonso and Paul Dijkstra
PART 4 Cardiovascular Management 371
34 Guidelines for Sports Practice in Athletes with Cardiovascular Disease 373
Andrew D Silva and Sanjay Sharma
35 Management of the Symptomatic Athlete 385
Meagan M. Wasfy and Aaron L. Baggish
36 Management of Abnormal Physical Examination Findings in Athletes 395
Victoria Watt, Mats Börjesson and Mikael Dellborg
37 Management of Atrial Fibrillation in Athletes 406
Eduard Guasch and Lluis Mont
38 Implantable Cardioverter ]Defibrillators in Athletes 415
Victoria Watt
39 Management of Hypertension in Athletes 427
Maria ]Carmen Adamuz
PART 5 Conundrums in Sports Cardiology 439
40 Distinguishing Physiological Left Ventricular Hypertrophy from Hypertrophic Cardiomyopathy in Athletes 441
Aneil Malhotra and Sanjay Sharma
41 Screening for Cardiovascular Disease in the Older Athlete 449
Mats Börjesson
42 Is Ultra ]Endurance Exercise Damaging to the Right Ventricle? 457
Guido Claessen and Hein Heidbuchel
43 Clinical Implications of Performance ]Enhancing Drugs for Cardiovascular Health 468
Peter J. Angell and Yorck O. Schumacher
44 Cardiovascular Concerns in the Paralympic Athlete 475
Cindy J. Chang and Suzy Kim
PART 6 Emergency Cardiac Care 483
45 Emergency Cardiac Care in the Athletic Setting: From School Sports to the Olympic Arena 485
Efraim Kramer and Martin Botha
PART 7 Sports Cardiology Training 493
46 Recommendations for Sports Cardiology Training for the Sports Medicine Physician 495
Irfan M. Asif and Jonathan A. Drezner
Index, 503
