Medical researchers have developed new guidelines that suggest athletes with cardiovascular abnormalities may be able to safely participate in competitive sports, marking a significant shift from previous restrictive approaches. The joint scientific statement from the American Heart Association and American College of Cardiology emphasizes the importance of shared decision-making between athletes and healthcare professionals. Dr. Jonathan H. Kim, chair of the writing group, highlighted that historically, athletes with cardiac issues were automatically prohibited from sports participation.
The new guidelines recognize the complexity of cardiac adaptations in athletes and acknowledge that not all cardiovascular conditions present uniform risks. Key updates include more nuanced recommendations for athletes with conditions such as cardiomyopathies, myocarditis, and genetic heart rhythm disorders. For instance, previous blanket restrictions on athletes with cardiomyopathies have been replaced with recommendations for individual clinical assessment and potential sports participation. The statement also introduces specific considerations for diverse athlete populations, including Masters athletes over 35 years old, extreme sports participants, and pregnant athletes.
Researchers emphasized the need for comprehensive pre-participation cardiac screening, recommending a 14-point evaluation that includes physical examinations, medical history review, and potentially an electrocardiogram. Notably, the research identified significant knowledge gaps, particularly regarding how sports participation impacts the health of athletes with cardiovascular conditions. The Outcomes Registry for Cardiac Conditions in Athletes (ORCCA) study has been established to monitor clinical outcomes and address these information deficits. More information about this registry can be found at https://www.heart.org/en/professional/quality-improvement/outcomes-registry-for-cardiac-conditions-in-athletes.
An important aspect of the research highlighted potential health disparities, with Dr. Kim noting that young Black athletes appear to have a higher sudden cardiac death risk, though the underlying reasons remain unclear. The statement calls for further investigation into these social health disparities. The new guidelines represent a more personalized, evidence-based approach to sports participation for athletes with heart conditions, prioritizing individual risk assessment and collaborative medical decision-making. Additional details about the guidelines are available at https://www.acc.org/latest-in-cardiology/clinical-statements.
