Sports Cardiology, An Issue of Clinics in Sports Medicine , livre ebook

Clinics Review Articles CLINICS IN SPORTS MEDICINE
Sports Cardiology

Robert W. Battle, MD, FACC
University of Virginia Health Systems, Charlottesville, VA, USA
ISSN  0278-5919 Volume 34 • Number 3 • July 2015
Elsevier
Table of Contents
Cover image
Title page
Copyright
Contributors
Consulting Editor
Editor
Authors
Forthcoming Issues
Forthcoming Issues
Recent Issues
Foreword
Preface: Sports Cardiology: A Discipline Emerged
The Impact of Sports Cardiology on the Practice of Primary Care Sports Medicine
Key points
Introduction
The preparticipation evaluation—Where were we, where are we?
A practical approach to a complex problem—Where are we headed?
The Cardiovascular Physiology of Sports and Exercise
Key points
Introduction
Principles of exercise physiology
The oxygen cascade and quantifying aerobic fitness
Variables monitored during exercise testing and their physiologic interpretation
Summary
Cardiovascular Adaptation and Remodeling to Rigorous Athletic Training
Key points
Introduction
Overview of relevant exercise physiology
Structural and functional cardiac adaptations
Determinants of adaptation
Uncertainties and areas for future work
Summary
The Electrocardiogram in Highly Trained Athletes
Key points
Introduction
Group 1 European Society of Cardiology criteria
Group 2 European Society of Cardiology criteria
Summary
Advanced Imaging of Athletes
Key points
Introduction
Imaging background
Cardiomyopathies
Arterial disease
Aortic root dilation
Summary
Supplementary data
Cardiovascular Concerns in Water Sports
Key points
Depth and pressure
Boyle’s law
Henry’s law
Immersion
Diving
Summary
Diseases of the Aorta in Elite Athletes
Key points
Introduction
Conditions associated with aortic disease
Management of athletes with aortic disease
Athletes with Implantable Cardioverter Defibrillators
Key points
Introduction
Examination of guideline-based recommendations for athletes and arrhythmias
Challenging the current recommendations: is it really evidence-based practice?
Practical considerations of implantable cardioverter defibrillators in athletes
Summary
Sports and Exercise in Athletes with Hypertrophic Cardiomyopathy
Key points
Hypertrophic cardiomyopathy: epidemiology, pathophysiology, diagnosis, clinical course, and treatment
The birth of guidelines: Bethesda and beyond
Comparisons to European guidelines
The evidence behind the guidelines
The cause of sudden cardiac death in hypertrophic cardiomyopathy is rooted in an electrically unstable substrate
Does exercise increase the risk of sudden cardiac death in hypertrophic cardiomyopathy?
The exercise paradox in hypertrophic cardiomyopathy
Challenging the guidelines
Defining the high-risk cohort
Other avenues of prevention
Medical-legal implications
Should he be allowed to play? The case of Nicholas Knapp
Future directions
Summary
Legal and Ethical Issues in the Cardiovascular Care of Elite Athletes
Key points
Introduction
Understanding legal standards
Evidence of the standard
Elite athletes versus the normal patient population
Limiting potential exposures
Preparticipation physical examination
Medical disqualification
Waivers
The second opinion
Energy drinks
Summary
Something Old, Something New
Key points
Introduction
Using family history to identify athletes at risk for sudden death
Cardiovascular genetic testing and the athlete
Summary
How to Practice Sports Cardiology
Key points
Introduction
How to practice sports cardiology: a practical approach to the sports-specific cardiovascular care of any athlete
Five-step approach to the cardiovascular care of an athlete: example of the professional soccer athlete
Knowledge base required to provide athlete cardiovascular care (sports cardiology)
Summary/Discussion
The Management of Athletes with Congenital Heart Disease
Key points
Exercise as medicine
Incidence and prevalence, basic anatomy, physiology, and natural history of common congenital cardiac lesions
Shunt versus pressure lesions
Pressure lesions as static exercise
Complex lesions with cyanosis
Congenital heart disease after intervention
Coronary anomalies—congenital and acquired
The practical approach
The Historical Perspective of Athletic Sudden Death
Key points
Introduction
Athletics and the athlete
Death in sport
Protecting the athlete: studying, discussing, screening, and preventing sudden cardiac death
Summary
Index
Copyright
ELSEVIER
1600 John F. Kennedy Boulevard • Suite 1800 • Philadelphia, Pennsylvania, 19103-2899
http://www.theclinics.com
CLINICS IN SPORTS MEDICINE Volume 34, Number 3
July 2015 ISSN 0278-5919, ISBN-13: 978-0-323-39119-1
Editor: Jennifer Flynn-Briggs
Developmental Editor: Donald Mumford
© 2015 Elsevier Inc. All rights reserved.
This periodical and the individual contributions contained in it are protected under copyright by Elsevier, and the following terms and conditions apply to their use:
Photocopying
Single photocopies of single articles may be made for personal use as allowed by national copyright laws. Permission of the Publisher and payment of a fee is required for all other photocopying, including multiple or systematic copying, copying for advertising or promotional purposes, resale, and all forms of document delivery. Special rates are available for educational institutions that wish to make photocopies for non-profit educational classroom use. For information on how to seek permission visit www.elsevier.com/permissions or call: (+44) 1865 843830 (UK)/(+1) 215 239 3804 (USA).
Derivative Works
Subscribers may reproduce tables of contents or prepare lists of articles including abstracts for internal circulation within their institutions. Permission of the Publisher is required for resale or distribution outside the institution. Permission of the Publisher is required for all other derivative works, including compilations and translations (please consult www.elsevier.com/permissions ).
Electronic Storage or Usage
Permission of the Publisher is required to store or use electronically any material contained in this periodical, including any article or part of an article (please consult www.elsevier.com/permissions ). Except as outlined above, no part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior written permission of the Publisher.
Notice
No responsibility is assumed by the Publisher for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions or ideas contained in the material herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made.
Although all advertising material is expected to conform to ethical (medical) standards, inclusion in this publication does not constitute a guarantee or endorsement of the quality or value of such product or of the claims made of it by its manufacturer.
Clinics in Sports Medicine (ISSN 0278-5919) is published quarterly by Elsevier Inc., 360 Park Avenue South, New York, NY 10010-1710. Months of issue are January, April, July, and October. Business and Editorial Offices: 1600 John F. Kennedy Blvd., Ste. 1800, Philadelphia, PA 19103-2899. Customer Service Office: 3251 Riverport Lane, Maryland Heights, MO 63043. Periodicals postage paid at New York, NY and additional mailing offices. Subscription prices are $340.00 per year (US individuals), $540.00 per year (US institutions), $165.00 per year (US students), $385.00 per year (Canadian individuals), $666.00 per year (Canadian institutions), $235.00 (Canadian students), $470.00 per year (foreign individuals), $666.00 per year (foreign institutions), and $235.00 per year (foreign students). Foreign air speed delivery is included in all Clinics subscription prices. All prices are subject to change without notice. POSTMASTER: Send address changes to Clinics in Sports Medicine , Elsevier Health Sciences Division, Subscription Customer Service, 3251 Riverport Lane, Maryland Heights, MO 63043. Customer Service (orders, claims, online, change of address): Elsevier Health Sciences Division, Subscription Customer Service, 3251 Riverport Lane, Maryland Heights, MO 63043. Tel: 1-800-654-2452 (U.S. and Canada); 314-447-8871 (outside U.S. and Canada). Fax: 314-447-8029. E-mail: journalscustomerservice-usa@elsevier.com (for print support) ; journalsonlinesupport-usa@elsevier.com (for online support) .
Reprints . For copies of 100 or more of articles in this publication, please contact the Commercial Reprints Department, Elsevier Inc., 360 Park Avenue South, New York, NY 10010-1710. Tel.: 212-633-3874; Fax: 212-633-3820; E-mail: reprints@elsevier.com .
Clinics in Sports Medicine is cov