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Sports Cardiology

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Sports cardiology is the field that extends support to athletes who have a high risk of suffering from myocardial infarction or are showing symptoms of heart failure. People who are in the field of sports cardiology should have experience in dealing with athletes and treating their disorders. Sports cardiology does not include only one cardiologist. There should be an entire team to monitor the athlete's overall health.

The team should include:-
  • A team of well-trained sports medicine physician
  • A team consisting of four to five skilled athletic trainers
  • A team of skilled physiotherapists
  • Four to five individuals who have experience in cardiac imaging(cardiac imaging specialists)
  • A team that includes five members belonging to the electrophysiology field( electrophysiologists) and exercise physiologists
  • A team of well-trained and skilled cardiologists and heart failure specialists
  • A single, senior, sports cardiologist will supervise the entire group.

Note: The number of people who will be treating and examining the patient will be restricted as per COVID norms.

Diseases And Risk Factors
Some diseases that affect athletes and other individuals in the sports field include:-
  • Cardiomyopathy - where a part of the heart thickens. It is most common in athletes since their hearts are large and have a low resting rate as compared to others. One of the main causes is due to genetic factors. In the case of inherited heart disease, arrhythmogenic right ventricular cardiomyopathy is mostly likely to occur which includes gene mutations in desmosomes(cell structures present in those tissues that experience intense mechanical stress)
  • Atrial Fibrillation - abnormal heart rhythm (arrhythmia) in the upper chambers of the heart(atria).
  • Wolff-Parkinson-White Syndrome - this is a medical condition caused due to an accessory pathway in the heart. An accessory pathway is an extra electrical pathway present between the upper and lower chambers of the heart. This results in rapid heartbeats, shortness of breath, chest pain, fatigue, dizziness, etc.
  • Long QT Syndrome - heartbeat disorder causing abnormal heart rhythms.
  • Coronary Artery Disease - is caused due to deposition of cholesterol in the walls of the coronary arteries. This reduces blood flow in the heart muscle, causing the tissues of the heart muscle to die. This is one of the main caused that sudden cardiac death takes place in athletes.
  • Commotio Cordis - means agitation of the heart in Latin, it occurs due to external causes( like a strong external hit on the chest) rather than internal factors like heart disease. This severely disrupts the heart rhythm.
  • Brugada Syndrome - comes under congenital heart disorder. This is caused when the electrical signals that help the individual cells of the heart to communicate, are disrupted, leading to a genetic mutation in the person's DNA. Symptoms include blacking out and sudden cardiac death.

In addition, certain risk factors that contribute to Sudden Cardiac Death in athletes include:-

  • Hypertension - High blood pressure since high blood pressure causes the heart muscle to work harder. This also puts a lot of pressure on the arteries.
  • Diabetes since high blood sugar levels runs the risk of hardening of coronary arteries caused by an increase in the number of cholesterol deposits in the walls of coronary arteries.
  • Smoking decreases the ability of the pulmonary vein to carry oxygenated blood to the heart, causing sudden cardiac death.
Regular Tests, Scans, And Treatment

To ensure that athletes or people participating in any sporting event are physically able to carry out the activities, sports cardiologists should get involved. This treatment takes place in two ways

  • Immediate treatment if the athlete has met with an accident such as sudden cardiac death and cardiac arrest.
  • Preventive measures are recommended to athletes who have a high risk of SCD or myocardial infarction.

Common tests that are done by Sports Cardiologist are:-

  • Electrophysiology study - This test is done to check abnormal heart rhythms. The patient is supposed to do this test with an empty stomach, which also includes that the patient cannot take any medicines that they have been prescribed before the test begins. The electrophysiology study (EPS) is done by inserting a sheath at the artery or vein. Through the sheath, the specialized catheters with be directed towards the heart. Electric impulses will be sent through the catheters which the heart will receive and send its electric signals. The catheters pick these signals which are recorded and seen with the help of the video screen attached to it. This procedure is also called cardiac mapping and it is done with athletes to check whether they have abnormal heart rhythms which is one of the main causes of myocardial infarction.
  • Cardiac Imaging - Techniques of cardiac imaging like echocardiography, a device called a transducer is placed on the top of the chest and ultrasonic waves are sent to the heart bounce off and show the live image of the heart, using a monitor. Intravascular ultrasound uses a catheter instead of a transducer to capture the images of coronary arteries. This helps the specialists to see whether the blood flow is obstructed or not. Cardiac imaging is done on athletes so that the cardiac imaging specialists have an idea about the condition of the patient's heart and will be able to recommend safety measures based on that information.
  • Stress Test - in many cases, athletes face a heart attack or even sudden death because their hearts cannot withstand the strenuous and vigorous activities they engage in. To avoid this situation, the cardiac stress test is done where their heart activity is monitored while they are undergoing vigorous training or while running on a treadmill. Cardiac stress tests like these are done by exercise physiologists under the supervision of a sports cardiologist.
  • Physical examination includes blood pressure test, triglyceride test to check the number of fatty acids in the body, coronary calcium scan to check calcium deposits in the coronary arteries that cause narrowing of the arteries and cause a heart attack, checking the rhythm of the heartbeat. The examiner might ask for any unusual changes that might have occurred in your body. This helps the examiner to analyze your medical history.
  • Remote Patient Monitoring - with the evolution of technology, advanced devices have contributed to improving the quality of the patient's life. Devices like blood pressure cuff, glucometer consists of sensors. If the device detects any abnormality in the blood pressure levels, the data is immediately transmitted to the healthcare providers. In this way, the healthcare providers are immediately aware of the patient's condition and take necessary steps accordingly.
Why Would Anyone Go To A Sports Cardiologist?

You might go or be consulted to a sports cardiologist if:-

  • You experience any deterioration in your athletic performance due to your previous condition
  • You are experiencing symptoms like chest pain, weakness while engaging in vigorous exercises
  • You are not convinced with your current treatment and need a more extensive cardiac care
  • You have a family history of cardiac diseases and want to discuss it with your sports cardiologist to know whether it might affect your performance
  • You want approval from your sports cardiologist to resume your participation after going through a particular treatment.

Dr. Swapnil Mate's Cardiology clinic has the best sports cardiology team in Pune that can provide quality treatment to individuals in the sports realm. Their team, supervised by an expert sports cardiologist, work with modern devices to improve patient-provider relationship. We recommend you to contact Dr. Swapnil Mate for the best medical assistance.

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