Updated Guidance: Athletes With Certain Heart Conditions Can Play Competitive Sports

Some athletes with cardiovascular abnormalities may be able to safely participate in competitive sports following shared decision-making with their doctors about potential risks, according to new research published in Circulation and simultaneously published in JACC.

The novel scientific statement “Clinical Considerations for Competitive Sports Participation for Athletes with Cardiovascular Abnormalities” lists appreciable changes based on evidence since its initial publication in 2015.

The update in messaging reflects recent advancements in the understanding of the “athlete’s heart,” which includes enhanced knowledge of the complex structural, functional, and electrical cardiac adaptations that occur following exercise. In the past decade, studies on cardiac conditions—from congenital heart disease to arrhythmias and more—suggest the risks of adverse cardiovascular events are not as high during competitive sports participation as previously thought and provide an evidence-based path for a safe return-to-play for many athletes.

Evidence-Based Updates

A few notable updates to the statement include:

· For athletes requiring blood thinning medications, the updated statement offers more guidance about how healthcare professionals can analyze their health risks based on the sport they play. For instance, certain activities need to be considered for athletes with a higher risk of trauma and bleeding, such as tackle football, competitive cycling, outdoor skiing, or baseball.

· Previously, athletes with cardiomyopathies were told not to compete in sports; however, under the new guidance, participating in sports may be possible for individuals with some genetic cardiomyopathies.

· Athletes with myocarditis were previously told to forego sports participation for three to six months; however, this advice was based on unsupported data. Current research indicates that the condition often improves within less than three months, meaning that many athletes may safely return to competitive sports sooner than previously believed.

“In the past, there was no shared decision-making about sports eligibility for athletes with heart disease. These athletes were automatically prohibited from participating in sports if almost any cardiac issue was present,” said writing group Chair Jonathan H. Kim, MD, MSc, FACC, an associate professor of medicine and director of sports cardiology at Emory University School of Medicine in Atlanta via an American Heart Association press release. “This new scientific statement reviews best clinical practices for athletes with certain cardiovascular conditions and how health care professionals can guide these athletes—from children to Masters athletes—in a shared decision-making discussion about potential risks and rewards.”

Source:

American Heart Association