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McCleery J, Diamond E, Kelly R, Li L, Ackerman KE, Adams WM, Kraus E. Centering the female athlete voice in a sports science research agenda: a modified Delphi survey with Team USA athletes. Br J Sports Med 2024:bjsports-2023-107886. [PMID: 38981661 DOI: 10.1136/bjsports-2023-107886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES To co-construct a sports medicine and exercise science research and translational agenda with Team USA elite female athletes serving as the experts on their health, performance and well-being. METHODS 40 Team USA female athletes across sports disciplines participated in an online, anonymous, modified Delphi survey by ranking topics on a Likert scale (1='strongly disagree' and 5='strongly agree') and providing qualitative justification regarding whether they believed having more information and research on each topic would support their athletic performance, health and well-being. After each Delphi round, quantitative rankings of topics and qualitative justifications were analysed, informing revisions to the list of topics for review in the subsequent round. Researchers provided athletes with a detailed report of findings and revisions following each round. RESULTS The final list contained 14 ranked topics. The top five were menstrual cycle symptoms (4.58±0.74), recovery (4.58±0.59), birth control (4.55±0.89), mental health (4.50±0.55) and fueling and the menstrual cycle (4.43±0.74). New topics originating from athletes included recovery, menstrual cycle symptoms, fueling and the menstrual cycle, mental health and sports performance, team dynamics, and institutionalised sexism. CONCLUSION This is the first study to co-construct a research and translational agenda with Team USA elite female athletes. The list of sports science research topics developed by focusing on elite female athletes' voices lays the foundation for future research and provides valuable insight into the specific needs of female athletes.
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Affiliation(s)
- Julie McCleery
- Center for Leadership in Athletics, University of Washington College of Education, Seattle, Washington, USA
| | - Ellie Diamond
- Female Athlete Science and Translational Research Program, Stanford University Department of Orthopaedic Surgery, Redwood City, California, USA
| | - Rose Kelly
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Longxi Li
- Center for Leadership in Athletics, University of Washington College of Education, Seattle, Washington, USA
| | - Kathryn E Ackerman
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - William M Adams
- Department of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
| | - Emily Kraus
- Female Athlete Science and Translational Research Program, Stanford University Department of Orthopaedic Surgery, Redwood City, California, USA
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Lampert R, Chung EH, Ackerman MJ, Arroyo AR, Darden D, Deo R, Dolan J, Etheridge SP, Gray BR, Harmon KG, James CA, Kim JH, Krahn AD, La Gerche A, Link MS, MacIntyre C, Mont L, Salerno JC, Shah MJ. 2024 HRS expert consensus statement on arrhythmias in the athlete: Evaluation, treatment, and return to play. Heart Rhythm 2024:S1547-5271(24)02560-8. [PMID: 38763377 DOI: 10.1016/j.hrthm.2024.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 05/21/2024]
Abstract
Youth and adult participation in sports continues to increase, and athletes may be diagnosed with potentially arrhythmogenic cardiac conditions. This international multidisciplinary document is intended to guide electrophysiologists, sports cardiologists, and associated health care team members in the diagnosis, treatment, and management of arrhythmic conditions in the athlete with the goal of facilitating return to sport and avoiding the harm caused by restriction. Expert, disease-specific risk assessment in the context of athlete symptoms and diagnoses is emphasized throughout the document. After appropriate risk assessment, management of arrhythmias geared toward return to play when possible is addressed. Other topics include shared decision-making and emergency action planning. The goal of this document is to provide evidence-based recommendations impacting all areas in the care of athletes with arrhythmic conditions. Areas in need of further study are also discussed.
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Affiliation(s)
- Rachel Lampert
- Yale University School of Medicine, New Haven, Connecticut
| | - Eugene H Chung
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | | | - Rajat Deo
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Joe Dolan
- Yale University School of Medicine, New Haven, Connecticut
| | | | - Belinda R Gray
- University of Sydney, Camperdown, New South Wales, Australia
| | | | | | | | - Andrew D Krahn
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Andre La Gerche
- Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Mark S Link
- UT Southwestern Medical Center, Dallas, Texas
| | | | - Lluis Mont
- Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Jack C Salerno
- University of Washington School of Medicine, Seattle, Washington
| | - Maully J Shah
- Childrens Hospital of Philadelphia, Philadelphia, Pennsylvania
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Friedman NMG, Koenig GJ, Marks JA, Hilton MT, Glick JE. Characteristics and outcomes of cardiac arrests reported in the national collegiate emergency medical services foundation data registry. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:690-693. [PMID: 35472006 DOI: 10.1080/07448481.2022.2066976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/24/2022] [Accepted: 04/10/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The objective of this study was to identify out-of-hospital cardiac arrest characteristics for patients treated by collegiate-based emergency medical services (CBEMS) organizations. PARTICIPANTS CBEMS organizations provided data via the National Collegiate EMS Foundation Cardiac Arrest Data Registry. METHODS CBEMS organization details, patient demographics, cardiac arrest characteristics and treatments, and prehospital outcomes for cases spanning October 2007 to May 2020 were analyzed with descriptive statistics. RESULTS There were 65 OHCA entries. The majority were for male patients (82%) and a notable number of cases occurred in patients 45 years of age or younger (41%). Cases were frequently witnessed (71%) with high rates of bystander cardiopulmonary resuscitation (57%) and defibrillation (29%) prior to EMS arrival. Almost half of the patients (48%) had achieved return of spontaneous circulation until care was transferred to a provider of equal/higher level. CONCLUSIONS CBEMS organizations may be well situated to respond rapidly to on-campus OHCAs.
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Affiliation(s)
- Nicholas M G Friedman
- National Collegiate Emergency Medical Services Foundation, West Sand Lake, New York, USA
- School of Medicine, Stanford University, Stanford, California, USA
| | - George J Koenig
- National Collegiate Emergency Medical Services Foundation, West Sand Lake, New York, USA
- Department of Surgery, Division of Acute Care Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Joshua A Marks
- National Collegiate Emergency Medical Services Foundation, West Sand Lake, New York, USA
- Department of Surgery, Division of Acute Care Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Michael T Hilton
- National Collegiate Emergency Medical Services Foundation, West Sand Lake, New York, USA
| | - Joshua E Glick
- National Collegiate Emergency Medical Services Foundation, West Sand Lake, New York, USA
- Department of Emergency Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
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4
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Petek BJ, Churchill TW, Moulson N, Kliethermes SA, Baggish AL, Drezner JA, Patel MR, Ackerman MJ, Kucera KL, Siebert DM, Salerno L, Suchsland MZ, Asif IM, Maleszewski JJ, Harmon KG. Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A 20-Year Study. Circulation 2024; 149:80-90. [PMID: 37955565 PMCID: PMC10843024 DOI: 10.1161/circulationaha.123.065908] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 08/24/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Understanding the incidence, causes, and trends of sudden cardiac death (SCD) among young competitive athletes is critical to inform preventive policies. METHODS This study included National Collegiate Athletic Association athlete deaths during a 20-year time frame (July 1, 2002, through June 30, 2022). Athlete deaths were identified through 4 separate independent databases and search strategies (National Collegiate Athletic Association resolutions list, Parent Heart Watch database and media reports, National Center for Catastrophic Sports Injury Research database, and insurance claims). Autopsy reports and medical history were reviewed by an expert panel to adjudicate causes of SCD. RESULTS A total of 143 SCD cases in National Collegiate Athletic Association athletes were identified from 1102 total deaths. The National Collegiate Athletic Association resolutions list identified 117 of 143 (82%), the Parent Heart Watch database or media reports identified 89 of 143 (62%), the National Center for Catastrophic Sports Injury Research database identified 63 of 143 (44%), and insurance claims identified 27 of 143 (19%) SCD cases. The overall incidence of SCD was 1:63 682 athlete-years (95% CI, 1:54 065-1:75 010). Incidence was higher in male athletes than in female athletes (1:43 348 [95% CI, 1:36 228-1:51 867] versus 1:164 504 [95% CI, 1:110 552-1:244 787] athlete-years, respectively) and Black athletes compared with White athletes (1:26 704 [1:20 417-1:34 925] versus 1:74 581 [1:60 247-1:92 326] athlete-years, respectively). The highest incidence of SCD was among Division I male basketball players (1:8188 [White, 1:5848; Black, 1:7696 athlete-years]). The incidence rate for SCD decreased over the study period (5-year incidence rate ratio, 0.71 [95% CI, 0.61-0.82]), whereas the rate of noncardiovascular deaths remained stable (5-year incidence rate ratio, 0.98 [95% CI, 0.94-1.04]). Autopsy-negative sudden unexplained death (19.5%) was the most common postmortem examination finding, followed by idiopathic left ventricular hypertrophy or possible cardiomyopathy (16.9%) and hypertrophic cardiomyopathy (12.7%), in cases with enough information for adjudication (118 of 143). Eight cases of death were attributable to myocarditis over the study period (1 case from January 1, 2020, through June 30, 2022), with none attributed to COVID-19 infection. SCD events were exertional in 50% of cases. Exertional SCD was more common among those with coronary artery anomalies (100%) and arrhythmogenic cardiomyopathy (83%). CONCLUSIONS The incidence of SCD in college athletes has decreased. Male sex, Black race, and basketball are associated with a higher incidence of SCD.
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Affiliation(s)
- Bradley J. Petek
- Sports Cardiology Program, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
- Division of Cardiology, Massachusetts General Hospital, Boston, MA
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, MA
| | - Timothy W. Churchill
- Division of Cardiology, Massachusetts General Hospital, Boston, MA
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, MA
| | - Nathaniel Moulson
- Division of Cardiology and Sports Cardiology BC, University of British Columbia, Vancouver, BC, Canada
| | | | - Aaron L. Baggish
- Division of Cardiology, Massachusetts General Hospital, Boston, MA
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, MA
- Swiss Olympic Medical Center, Lausanne University Hospital (CHUV), Lusanne, Switzerland
- Institute for Sport Science, University of Lausanne (ISSUL), Lusanne, Switzerland
| | - Jonathan A. Drezner
- Department of Family Medicine and Center for Sports Cardiology, University of Washington, Seattle, WA
| | - Manesh R. Patel
- Division of Cardiology, Duke Heart Center, and Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Michael J. Ackerman
- Department of Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN
- Department of Cardiovascular Medicine (Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic), Mayo Clinic, Rochester, MN
- Department of Pediatric and Adolescent Medicine (Division of Pediatric Cardiology), Mayo Clinic
| | - Kristen L. Kucera
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - David M. Siebert
- Department of Family Medicine and Center for Sports Cardiology, University of Washington, Seattle, WA
| | - Lauren Salerno
- Department of Family Medicine and Center for Sports Cardiology, University of Washington, Seattle, WA
| | - Monica Zigman Suchsland
- Department of Family Medicine and Center for Sports Cardiology, University of Washington, Seattle, WA
| | - Irfan M. Asif
- Family and Community Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL
| | | | - Kimberly G. Harmon
- Department of Family Medicine and Center for Sports Cardiology, University of Washington, Seattle, WA
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5
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McCarthy TP, Stokes DJ, Frank RM, McCarty EC. On-Field Sports Emergencies. Clin Sports Med 2023; 42:335-344. [DOI: 10.1016/j.csm.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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Abstract
ABSTRACT Introduction: The study and collection of athletes’ heart function index parameters and the correct and reasonable evaluation of body functions can effectively adjust training plans and avoid athletes’ bodily exhaustion. Objective: To study the diagnosis of myocardial injury by cardiovascular monitoring in athletes from two aspects: extraction of characteristic parameters of heart function and research of signal processing. Methods: The heart function intelligent evaluation algorithm was studied by using multi-source information fusion, and embedded technology; miniature sensors were used as well. Results: The incidence of severe ventricular arrhythmia was lower in both groups. The incidence of sinus arrhythmia and intermittent second degree I atrioventricular block in the high-intensity group was significantly higher than that in the control group. The number of atrial and ventricular premature beats was lower in the control group, but increased significantly in the high-intensity group. Conclusions: This study applied the theory of multi-source information fusion to carry out representative research on the intelligent monitoring and evaluation of the heart function of elite athletes, centering on the application requirements of the heart function monitoring of elite athletes. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
| | - Chang Sun
- Qiqihar Institute of Engineering, China
| | - Jie Bai
- Qiqihar Medical University, China
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Soar J, Böttiger BW, Carli P, Couper K, Deakin CD, Djärv T, Lott C, Olasveengen T, Paal P, Pellis T, Perkins GD, Sandroni C, Nolan JP. [Adult advanced life support]. Notf Rett Med 2021; 24:406-446. [PMID: 34121923 PMCID: PMC8185697 DOI: 10.1007/s10049-021-00893-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 12/19/2022]
Abstract
These European Resuscitation Council Advanced Life Support guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the prevention of and ALS treatments for both in-hospital cardiac arrest and out-of-hospital cardiac arrest.
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Affiliation(s)
- Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol, Großbritannien
| | - Bernd W. Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, Universitätsklinikum Köln, Köln, Deutschland
| | - Pierre Carli
- SAMU de Paris, Center Hospitalier Universitaire Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, and Université Paris Descartes, Paris, Frankreich
| | - Keith Couper
- Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Großbritannien
- Warwick Medical School, University of Warwick, Coventry, Großbritannien
| | - Charles D. Deakin
- University Hospital Southampton NHS Foundation Trust, Southampton, Großbritannien
- South Central Ambulance Service NHS Foundation Trust, Otterbourne, Großbritannien
| | - Therese Djärv
- Dept of Acute and Reparative Medicine, Karolinska University Hospital, Stockholm, Schweden
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Schweden
| | - Carsten Lott
- Department of Anesthesiology, University Medical Center, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Theresa Olasveengen
- Department of Anesthesiology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norwegen
| | - Peter Paal
- Department of Anaesthesiology and Intensive Care Medicine, Hospitallers Brothers Hospital, Paracelsus Medical University, Salzburg, Österreich
| | - Tommaso Pellis
- Department of Anaesthesia and Intensive Care, Azienda Sanitaria Friuli Occidentale, Pordenone, Italien
| | - Gavin D. Perkins
- Warwick Medical School and University Hospitals Birmingham NHS Foundation Trust, University of Warwick, Coventry, Großbritannien
| | - Claudio Sandroni
- Department of Intensive Care, Emergency Medicine and Anaesthesiology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rom, Italien
- Institute of Anaesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rom, Italien
| | - Jerry P. Nolan
- Warwick Medical School, Coventry, Großbritannien, Consultant in Anaesthesia and Intensive Care Medicine Royal United Hospital, University of Warwick, Bath, Großbritannien
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8
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Soar J, Böttiger BW, Carli P, Couper K, Deakin CD, Djärv T, Lott C, Olasveengen T, Paal P, Pellis T, Perkins GD, Sandroni C, Nolan JP. European Resuscitation Council Guidelines 2021: Adult advanced life support. Resuscitation 2021; 161:115-151. [PMID: 33773825 DOI: 10.1016/j.resuscitation.2021.02.010] [Citation(s) in RCA: 454] [Impact Index Per Article: 151.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
These European Resuscitation Council Advanced Life Support guidelines, are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the prevention of and ALS treatments for both in-hospital cardiac arrest and out-of-hospital cardiac arrest.
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Affiliation(s)
- Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
| | - Bernd W Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Pierre Carli
- SAMU de Paris, Centre Hospitalier Universitaire Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, and Université Paris Descartes, Paris, France
| | - Keith Couper
- Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Warwick Medical School, University of Warwick, Coventry,UK
| | - Charles D Deakin
- University Hospital Southampton NHS Foundation Trust, Southampton, UK; South Central Ambulance Service NHS Foundation Trust, Otterbourne,UK
| | - Therese Djärv
- Dept of Acute and Reparative Medicine, Karolinska University Hospital, Stockholm, Sweden, Department of Medicine Solna, Karolinska Institutet,Stockholm, Sweden
| | - Carsten Lott
- Department of Anesthesiology, University Medical Center, Johannes Gutenberg-Universitaet Mainz, Germany
| | - Theresa Olasveengen
- Department of Anesthesiology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Peter Paal
- Department of Anaesthesiology and Intensive Care Medicine, Hospitallers Brothers Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Tommaso Pellis
- Department of Anaesthesia and Intensive Care, Azienda Sanitaria Friuli Occidentale, Italy
| | - Gavin D Perkins
- University of Warwick, Warwick Medical School and University Hospitals Birmingham NHS Foundation Trust, Coventry, UK
| | - Claudio Sandroni
- Department of Intensive Care, Emergency Medicine and Anaesthesiology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy; Institute of Anaesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Jerry P Nolan
- University of Warwick, Warwick Medical School, Coventry, CV4 7AL; Royal United Hospital, Bath, UK
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Comparison of cardiovascular screening in college athletes by history and physical examination with and without an electrocardiogram: Efficacy and cost. Heart Rhythm 2020; 17:1649-1655. [PMID: 32380289 DOI: 10.1016/j.hrthm.2020.04.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/19/2020] [Accepted: 04/23/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Preparticipation screening for conditions associated with sudden cardiac death (SCD) is required in college athletes. Previous cost analyses used theoretical models based on variable assumptions, but no study used real-life outcomes. OBJECTIVE The purpose of this study was to compare disease prevalence, positive findings, and costs of 2 different screening strategies: history and physical examination alone (H&P) or with an electrocardiogram (H&P+ECG). METHODS De-identified preparticipation data (2009-2017) from Pacific-12 Conference institutions were abstracted for cardiovascular history questions, cardiovascular physical examination, and ECG result. Secondary testing, cardiac diagnoses, return to play outcomes, and complications from testing were recorded. The costs of screening and secondary testing were based on the Centers for Medicare & Medicaid Services Physician Fee Schedule. RESULTS A total of 8602 records (4955 H&P, 3647 H&P+ECG) were included. Eleven conditions associated with SCD were detected (2 H&P only, 9 H&P+ECG). The prevalence of cardiovascular conditions associated with SCD discovered with H&P alone was 0.04% (1/2454) compared to 0.24% (1/410) when ECG was added (P = .01) (odds ratio 5.17; 95% confidence interval 1.28-20.85; P = .02). Cost of screening and secondary testing with H&P alone was $130 per athlete and in the ECG-added group was $152 per athlete. The cost per diagnosis was $312,407 in the H&P group and $61,712 in the ECG-added group. There were no adverse outcomes from secondary testing or treatment. CONCLUSION H&P with the addition of ECG is 6 times more likely to detect a cardiovascular condition associated with SCD than without. The addition of ECG improves the cost efficiency per diagnosis by 5-fold and should be considered at college institutions with appropriate resources.
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11
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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.
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Affiliation(s)
- David M Siebert
- Department of Family Medicine, UW Medicine Center for Sports Cardiology, University of Washington, 3800 Montlake Boulevard NE, Seattle, WA 98195, USA.
| | - Jonathan A Drezner
- Department of Family Medicine, UW Medicine Center for Sports Cardiology, University of Washington, 3800 Montlake Boulevard NE, Seattle, WA 98195, USA
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12
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Sideline Management of Nonmusculoskeletal Injuries by the Orthopaedic Team Physician. J Am Acad Orthop Surg 2019; 27:e146-e155. [PMID: 30308529 DOI: 10.5435/jaaos-d-17-00237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Although recognized as the most well-trained providers to address musculoskeletal injuries, many orthopaedic surgeons do not routinely treat patients with nonmusculoskeletal issues in their clinical practice. Nonetheless, when serving as a team physician, an orthopaedic surgeon may need to initiate management of or manage many nonmusculoskeletal issues. Knowing how to accurately diagnose and initiate management of sports-related medical and surgical conditions is an important facet of being an orthopaedic team physician. Common systems that may be involved include the cerebral/neurologic, ocular, dental, respiratory/pulmonary, cardiac, abdominal, and genitourinary systems. Each of these systems has specific pathologic processes and risks related to athletic or sporting participation. Orthopaedic team physicians must have a baseline familiarity with the most common nonmusculoskeletal issues to provide comprehensive quality care to athletes and patients.
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13
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Johri AM, Poirier P, Dorian P, Fournier A, Goodman JM, McKinney J, Moulson N, Pipe A, Philippon F, Taylor T, Connelly K, Baggish AL, Krahn A, Sharma S. Canadian Cardiovascular Society/Canadian Heart Rhythm Society Joint Position Statement on the Cardiovascular Screening of Competitive Athletes. Can J Cardiol 2019; 35:1-11. [DOI: 10.1016/j.cjca.2018.10.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 12/15/2022] Open
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14
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Siebert DM, Drezner JA. Sudden cardiac arrest on the field of play: turning tragedy into a survivable event. Neth Heart J 2018; 26:115-119. [PMID: 29411289 PMCID: PMC5818383 DOI: 10.1007/s12471-018-1084-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Sudden cardiac arrest remains the leading cause of death in exercising athletes, and recent studies have shown that it occurs more frequently than historical estimates. While out-of-hospital cardiac arrest often proves fatal, advance preparation can improve outcomes and the chance of survival. First responders to a collapsed athlete on the field of play may include team medical personnel, coaches, other athletes, officials, venue staff, emergency medical services personnel, or lay bystanders. Prompt and accurate recognition of sudden cardiac arrest, a comprehensive and rehearsed emergency action plan, early cardiopulmonary resuscitation, and immediate access to and use of an automated external defibrillator are each pivotal links in the chain of survival. This review summarises the components of an effective emergency action plan, highlights the critical role of automated external defibrillators, and reviews the diagnosis and management of sudden cardiac arrest on the field of play.
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Affiliation(s)
- David M Siebert
- Department of Family Medicine, UW Medicine Center for Sports Cardiology, University of Washington, 98195, Seattle, WA, USA.
| | - Jonathan A Drezner
- Department of Family Medicine, UW Medicine Center for Sports Cardiology, University of Washington, 98195, Seattle, WA, USA
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15
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Idriss SF, Berger S, Harmon KG, Kindman A, Kleiman R, Lopez-Anderson M, Molossi S, Saarel TE, Strnadova C, Todaro T, Shinagawa K, Morrow V, Krucoff M, Vetter V, Wright TJ. Prevention of sudden cardiac death in the young: Developing a rational, reliable, and sustainable national health care resource. A report from the Cardiac Safety Research Consortium. Am Heart J 2017; 190:123-131. [PMID: 28760206 DOI: 10.1016/j.ahj.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 05/15/2017] [Indexed: 11/28/2022]
Abstract
This White Paper, prepared by members of the Cardiac Safety Research Consortium, discusses important issues regarding sudden cardiac death in the young (SCDY), a problem that does not discriminate by gender, race, ethnicity, education, socioeconomic level, or athletic status. The occurrence of SCDY has devastating impact on families and communities. Sudden cardiac death in the young is a matter of national and international public health, and its prevention has generated deep interest from multiple stakeholders, including families who have lost children, advocacy groups, academicians, regulators, and the medical industry. To promote scientific and clinical discussion of SCDY prevention and to germinate future initiatives to move this field forward, a Cardiac Safety Research Consortium-sponsored Think Tank was held on February 21, 2015 at the US Food and Drug Administration's White Oak facilities, Silver Spring, MD. The ultimate goal of the Think Tank was to spark initiatives that lead to the development of a rational, reliable, and sustainable national health care resource focused on SCDY prevention. This article provides a detailed summary of discussions at the Think Tank and descriptions of related multistakeholder initiatives now underway: it does not represent regulatory guidance.
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Affiliation(s)
- Salim F Idriss
- Division of Cardiology, Department of Pediatrics, Duke University Medical Center Durham, NC
| | - Stuart Berger
- Division of Pediatric Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Kimberly G Harmon
- Departments of Family Medicine and Orthopaedics and Sports Medicine, University of Washington, Seattle, WA
| | | | | | | | - Silvana Molossi
- Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
| | | | - Colette Strnadova
- Health Products and Food Branch-Health Canada, Government of Canada, Ontario, Canada
| | | | | | | | - Mitchell Krucoff
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC
| | - Victoria Vetter
- Department of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Theressa J Wright
- GPS Cardiology, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN
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