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Updated 2015 ACC/AHA Guidelines on Competitive Athletes with Cardiovascular Abnormalities

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Updated 2015 ACC/AHA Guidelines on Competitive Athletes with Cardiovascular Abnormalities

Post by Dave Tuttle on Tue Dec 15, 2015 8:07 am

http://www.athletesheart.org/2015/12/updated-2015-accaha-guidelines-on-competitive-athletes-with-cardiovascular-abnormalities/

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Re: Updated 2015 ACC/AHA Guidelines on Competitive Athletes with Cardiovascular Abnormalities

Post by twal on Tue Dec 15, 2015 7:12 pm

Good document. Nothing too surprising.

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Re: Updated 2015 ACC/AHA Guidelines on Competitive Athletes with Cardiovascular Abnormalities

Post by Dave Tuttle on Wed Dec 16, 2015 10:15 am

Seems like the recommendations have been getting quite a bit more encouraging in recent years at least for CAD patients. Anyone remember what they were 10 years ago?

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Re: Updated 2015 ACC/AHA Guidelines on Competitive Athletes with Cardiovascular Abnormalities

Post by RoadKillBill on Fri Dec 18, 2015 5:15 am

From the 36th Bethesda Conference 2005
https://www.sads.org/images/stories/exercise/bethesda05.pdf

Recommendations: (for COMPETITIVE sport)





1. Athletes in the mildly increased risk group can participate in low dynamic and low/moderate static competitive sports (classes IA and IIA—see Fig. 1 in Task Force 8: Classification of Sports) but should avoid intensely competitive situations. We recognize that selected athletes with mildly increased risk may be permitted to compete in sports of higher levels of intensity when their overall clinical profile suggests very low exercise risk. This is particularly true for athletes in whom the only indication that coronary atherosclerosis is present is from an EBCT performed for screening purposes, and in which the total coronary calcium score is relatively low (i.e., less than 15). Increasing amounts of coronary calcium, suggestive of increasing burden disease, should dictate a more cautious approach, particularly if the coronary calcium score is more than 100. All athletes should understand that the risk of a cardiac event with exertion is probably increased once coronary atherosclerosis of any severity is present. Athletes with mildly increased risk engaging in competitive sports should undergo re-evaluation of their risk stratification at least annually.


2. Athletes in the substantially increased risk category should generally be restricted to low-intensity competitive sports (class IA).

3. Athletes should be informed of the nature of prodromal symptoms (such as chest, arm, jaw and shoulder discomfort, unusual dyspnea) and should be instructed to cease their sports activity promptly and to contact their physician if symptoms appear. Physicians should be aware that competitive athletes may minimize symptoms that occur during exertion.


4. Those with a recent MI or myocardial revascularization should cease their athletic training and competition until recovery is deemed complete. This interval varies among patient groups, but depends on the severity of the cardiovascular event and the extent and success of the revascularization procedure. Such patients may benefit from cardiac rehabilitation during the recovery period. No firm guidelines exist for how long patients should avoid vigorous exercise training, but in general, patients post-stent placement for stable CAD symptoms should avoid vigorous exercise training for competition for approximately four weeks. Patients undergoing stent placement for unstable disease should wait at least this long. Following coronary bypass surgery, patients should avoid vigorous training until their incisions can tolerate vigorous activity. After recuperation period, the risk and activity level should be defined as in recommendations 1 and 2.

5. All athletes with atherosclerotic CAD should have their atherosclerotic risk factors aggressively treated as studies suggest that comprehensive risk reduction is likely to stabilize coronary lesions and may reduce the risk of exercise-related events.

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