Detection and Management of Heart Disease in Athletes

Prim Care. 2020 Mar;47(1):19-35. doi: 10.1016/j.pop.2019.11.001. Epub 2019 Nov 9.

Abstract

Primary care clinicians fulfill critical roles of screening for, diagnosing, and managing cardiovascular disease. In young athletes, primary structural and electrical diseases are the focus. Coronary artery disease is the chief concern in older athletes. Sudden cardiac arrest may be the initial presentation of disease and is more common in young athletes than historically appreciated. The traditional preparticipation evaluation, or sports physical, is limited in its ability to accurately raise suspicion of underlying disease. The 12-lead electrocardiogram is a more accurate screening tool. Contemporary risk stratification and treatment protocols may allow for safe return to sport on a case-by-case basis.

Keywords: Athlete; Athlete’s heart; Cardiovascular disease; Electrocardiogram; International Criteria; Preparticipation physical evaluation (PPE); Sports cardiology; Sudden cardiac arrest.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Athletes*
  • Cardiovascular Diseases / diagnosis
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control*
  • Electrocardiography*
  • Female
  • Heart Disease Risk Factors
  • Heart Diseases / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Physical Examination
  • Risk Assessment
  • Sports Medicine