The preventive aspect of Sports Cardiology aligns slightly more with the specialty of Sports Medicine (doctors who look after athletes and exercising people), acute response with Emergency medicine, whereas the management of athletes with known heart disease is more aligned with the Cardiology side of Sports Cardiology. Sports Cardiology as a cardiology subspecialty overlaps with Electrophysiology, Cardiac Stress Testing, Echocardiography and other cardiac imaging, Genetic testing, and Cardiomyopathy. Screening of athletes to prevent SCD is a controversial area. Generally  medical screening is considered to be potentially valuable for conditions or diseases that are relatively common and not useful for conditions that are rare, due to the likely high number of false positives. SCD is rare and hence screening necessarily has a high rate of false positives (that is, athletes flagged as being potentially unsafe to participate in high level sport but who would not die if they did continue to play sport). Nevertheless, because of the fear of SCD and occupational requirement to train and compete at extremely high intensity in professional and elite sport, screening is established as a standard of care in many countries of the world. The country with the most established program of screening for cardiac disease in athletes is Italy, which requires this to be done by law. Over many decades the rate of SCD in Italy has reduced, probably due to nationwide screening. Some experts question whether the rate may have been reduced through other means, and whether the disqualification of many young people from playing vigorous sport annually is worth it. Event planning is therefore a key component of Sports Cardiology, even though event planning would not normally be a concern of a medical specialty . Making sure that there are sufficiently trained medical, paramedical and other trained staff or volunteers at sporting events, ready availability of AEDs or ambulances or both, and that those qualified people are ready to respond to an arrest, probably leads to a greater lowering of the rates of sudden cardiac death in sport than any other measure. Hence, having an excellent understanding of the parameters of safe event planning is a core subject in Sports Cardiology. Hypertrophic cardiomyopathy (HCM) or HOCM (O = obstructive) is considered the most common cause of sudden cardiac death in young athletes that may be preventable. However  the difficulty is that it overlaps with the more Athlete Heart syndrome and vast majority of discovered cases are mild, making it unclear about whether it is safe to continue playing intense sport. Long QT syndrome is a familial condition that is uncommon , but is a known source of sudden death in young people. It can cause cardiac arrest during athletic activity but also when doing other activities that raise heart rate. Atrial fibrillation (AF) is more common in the inactive, elderly population than the inactive young population. There is a reverse J-shaped curve, however, in that elite athletes doing very arduous sport have a higher rate of AF than moderately active people. Whereas the AF that occurs in the inactive elderly population is known to be associated with increase risk of stroke, it is unknown whether athletic AF increases the risk of sudden death or stroke. AF in athletes can be treated with a minimally-invasive procedure known as ablation.
The preventive aspect of Sports Cardiology aligns slightly more with the speciality of Sports Medicine (doctors who look after athletes and exercising people), acute response with Emergency medicine, whereas the management of athletes with known heart disease is more aligned with the Cardiology side of Sports Cardiology. Sports Cardiology as a cardiology subspecialty overlaps with Electrophysiology, Cardiac Stress Testing, Echocardiography and other cardiac imaging, Genetic testing, and Cardiomyopathy. Screening of athletes to prevent SCD is a controversial area. Generally , medical screening is considered to be potentially valuable for conditions or diseases that are relatively common and not useful for conditions that are rare, due to the likely high number of false positives. SCD is rare and hence screening necessarily has a high rate of false positives (that is, athletes flagged as being potentially unsafe to participate in high-level sport but who would not die if they did continue to play sport). Nevertheless, because of the fear of SCD and occupational requirement to train and compete at extremely high intensity in professional and elite sport, screening is established as a standard of care in many countries of the world. The country with the most established program of screening for cardiac disease in athletes is Italy, which requires this to be done by law. Over many decades the rate of SCD in Italy has reduced, probably due to nationwide screening. Some experts question whether the rate may have been reduced through other means, and whether the disqualification of many young people from playing vigorous sport annually is worth it. Event planning is therefore a key component of Sports Cardiology, even though event planning would not normally be a concern of a medical speciality . Making sure that there are sufficiently trained medical, paramedical and other trained staff or volunteers at sporting events, ready availability of AEDs or ambulances or both, and that those qualified people are ready to respond to an arrest, probably leads to a greater lowering of the rates of sudden cardiac death in sport than any other measure. Hence, having an excellent understanding of the parameters of safe event planning is a core subject in Sports Cardiology. Hypertrophic cardiomyopathy (HCM) or HOCM (O = obstructive) is considered the most common cause of sudden cardiac death in young athletes that may be preventable. However , the difficulty is that it overlaps with the more Athlete Heart syndrome and vast majority of discovered cases are mild, making it unclear about whether it is safe to continue playing intense sport. Long QT syndrome is a familial condition that is uncommon but is a known source of sudden death in young people. It can cause cardiac arrest during athletic activity but also when doing other activities that raise heart rate. Atrial fibrillation (AF) is more common in the inactive, elderly population than the inactive young population. There is a reverse J-shaped curve, however, in that elite athletes doing very arduous sport have a higher rate of AF than moderately active people. Whereas the AF that occurs in the inactive elderly population is known to be associated with increased risk of stroke, it is unknown whether athletic AF increases the risk of sudden death or stroke. AF in athletes can be treated with a minimally-invasive procedure known as ablation.
R
specialty
speciality
A
,
R
high level
high-level
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specialty
speciality
A
,
D
,
R
increase
increased