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. 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
Contributors, x Foreword, xiii Preface, xiv PART 1 The Cardiovascular System 1 1 Anatomy and Physiology of the Heart 3Keith P. George and Nathan Riding 2 The Vascular System 13N. Tim Cable 3 Energy Production Pathways During Exercise 21Sébastien Racinais and Stéphane Perrey 4 Cardiovascular Responses to Exercise 32Julien D. Périard 5 The Athlete’s Heart: Impact of Age, Sex, Ethnicity and Sporting Discipline 43Tracey Keteepe?]Arachi and Nabeel Sheikh 6 Physical Activity in the Prevention and Management of Atherosclerotic Disease 53John P. Buckley PART 2 Preventing Sudden Cardiac Death in Athletes 63 7 Incidence and Aetiology of Sudden Cardiac Death in Athletes 65Kimberly G. Harmon 8 Cardiovascular Screening for the Prevention of Sudden Cardiac Death in Athletes 74Antonio Pelliccia and Domenico Corrado 9 Comparison of Pre?]participation Evaluations for Assessing Cardiovascular Risk in Athletes 82Ramy S. Abdelfattah and Mathew G. Wilson 10 Normal Electrocardiographic Findings in Athletes 95Mathew G. Wilson and Victoria Watt 11 Abnormal Electrocardiographic Findings in Athletes: Recognising Changes Suggestive of Cardiomyopathy 104Gherardo Finocchiaro and Michael Papadakis 12 Abnormal Electrocardiographic Findings in Athletes: Recognising Changes Suggestive of Primary Electrical Disease 114Jordan Prutkin 13 Effective Echocardiographic Assessment of the Athlete: Basic Examination to Advanced Imaging Techniques 128David Oxborough 14 Early Repolarisation in Athletes 147Greg Mellor and Elijah R. Behr 15 Clinical (Laboratory) Exercise Testing 153Jonathan Myers and Victor Froelicher 16 The Role of Cardiovascular Magnetic Resonance in the Assessment of Athletes 163Rory O’Hanlon 17 Genetic Testing for Cardiovascular Conditions Predisposing to Sudden Death 175Colleen 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 191Mary N. Sheppard Section 2: Inherited and Congenital Cardiovascular Pathologies 203 19 Hypertrophic Cardiomyopathy 205David S. Owens 20 Arrhythmogenic Right Ventricular Cardiomyopathy 217Alessandro Zorzi and Domenico Corrado 21 Dilated Cardiomyopathy, Left Ventricular Hypertrabeculation and Noncompaction 231Sabiha Gati and Sanjay Sharma 22 Marfan Syndrome and Aortopathies 240Anne H. Child and Bethan Davies 23 Valvular Disease 247Kathleen E. Kearney and Catherine M. Otto 24 Congenital Heart Disease 263Guido E. Pieles and A. Graham Stuart 25 Congenital Coronary Artery Anomalies 275Cristina Basso and Gaetano Thiene Section 3: Ion Channelopathies, Accessory Pathways and Electrical Disease 287 26 Long QT Syndrome 289David J. Tester and Michael J. Ackerman 27 Brugada Syndrome 303Elena Arbelo and Josep Brugada 28 Wolff–Parkinson–White Syndrome 315Jack C. Salerno 29 Catecholaminergic Polymorphic Ventricular Tachycardia 324Leonie C.H. Wong and Elijah R. Behr 30 Idiopathic Ventricular Tachycardia/Ventricular Fibrillation 331André La Gerche Section 4: Acquired Disorders 341 31 Commotio Cordis 343Christopher Madias and Mark S. Link 32 Myocarditis 350Jeffrey 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 361Juan Manuel Alonso and Paul Dijkstra PART 4 Cardiovascular Management 371 34 Guidelines for Sports Practice in Athletes with Cardiovascular Disease 373Andrew D’Silva and Sanjay Sharma 35 Management of the Symptomatic Athlete 385Meagan M. Wasfy and Aaron L. Baggish 36 Management of Abnormal Physical Examination Findings in Athletes 395Victoria Watt, Mats Börjesson and Mikael Dellborg 37 Management of Atrial Fibrillation in Athletes 406Eduard Guasch and Lluis Mont 38 Implantable Cardioverter?]Defibrillators in Athletes 415Victoria Watt 39 Management of Hypertension in Athletes 427Maria?]Carmen Adamuz PART 5 Conundrums in Sports Cardiology 439 40 Distinguishing Physiological Left Ventricular Hypertrophy from Hypertrophic Cardiomyopathy in Athletes 441Aneil Malhotra and Sanjay Sharma 41 Screening for Cardiovascular Disease in the Older Athlete 449Mats Börjesson 42 Is Ultra?]Endurance Exercise Damaging to the Right Ventricle? 457Guido Claessen and Hein Heidbuchel 43 Clinical Implications of Performance?]Enhancing Drugs for Cardiovascular Health 468Peter J. Angell and Yorck O. Schumacher 44 Cardiovascular Concerns in the Paralympic Athlete 475Cindy 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 485Efraim Kramer and Martin Botha PART 7 Sports Cardiology Training 493 46 Recommendations for Sports Cardiology Training for the Sports Medicine Physician 495Irfan M. Asif and Jonathan A. Drezner Index, 503
Professor Mathew Wilson is Head of Athlete Health and Performance Research and is Lead Performance Physiologist at Aspetar (Qatar Orthopedic Sports Medicine Hospital, Qatar). He has led cardiovascular pre-participation screening programmes both within the United Kingdom and the Middle-East, and has been charged with the screening of over 15,000 high-level athletes at the Olympic Medical Institute (United Kingdom) and Aspetar (Qatar). Professor Jonathan Drezner is past-president of the American Medical Society for Sports Medicine, Director of the Center for Sports Cardiology and a sports medicine physician at the University of Washington, and team physician for the Seattle Seahawks NBA basketball team. Professor Drezner is a leading authority on the role of the automatic external defibrillator in preventing sudden cardiac death. Professor Sanjay Sharma is Medical Director of the Virgin London Marathon, Chair-Elect of the European Society of Cardiology (Sports Cardiology) nucleus group and leads the inherited cardiomyopathies and sports cardiology clinics at St George’s Hospital, London.
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.
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