Sports cardiology: your questions answered

Sports cardiology is a branch of cardiology that aims to care for the cardiac health of athletes. In his latest article, renowned cardiologist Dr Navin Chandra answers the most frequently asked questions about this growing branch of cardiology.

What is sports cardiology? Who does it apply to?

Sports cardiology is a growing field of cardiology, as more and more people become aware of the general importance of minimising their cardiovascular risk and improving their general health and well-being. As a result, people are becoming more and more active. Sports cardiology applies to all people who are active and want to check that their heart health is ok. This includes amateur athletes just starting out all the way up to elite athletes who compete on an international level.

What are the benefits of specialised sports cardiology care for active people?

The heart is like any muscle; any long-term, high-intensity exercises can lead to changes in the size and function of the heart. This is called physiological adaptation to exercise. In some rare cases, these changes can mimic heart muscle problems like cardiomyopathy or electrical heart problems. These are called pathological changes to the heart. it's vital that we're able to differentiate physiological, healthy changes in the heart from pathological, potentially serious heart muscle problems.

What is involved in a sports cardiology evaluation? Which types of tests are performed?

Sports cardiology evaluation is much like any form of medical evaluation. It begins with a careful clinical history which focuses on any symptoms that are present. In the context of sports cardiology or evaluating an athlete, it often focuses on the type, frequency and duration of exercise. There's often quite an important focus on family history because there can be certain genetic heart abnormalities that can predispose you to risk of adverse health issues if you're an athletic individual. We also focus a lot on social history, including:

• Alcohol intake
• Smoking
• Recreational or illicit drug use
• Performance-enhancing drug use

After that clinical examination, many tests can be done. We start with simple things like ECGs or echocardiograms to assess the heart in its resting state. This is done to assess things from an electrical and structural perspective. We then progress to testing the heart under exercise conditions. This is usually done on a treadmill or on a bicycle where we can take electrical recordings and take pictures and imaging of the heart at that time to examine for changes.

In some cases, we'll then go on to do more specialist tests such as MRI scans of the heart or in some people even genetic testing. This allows us to develop a clear understanding of how the heart is functioning at peak exertion and understand everyone's individual heart health and risk profile.

Which risk factors can make a person more likely to suffer from heart problems? Can they be genetic?

Active and athletic individuals do tend to represent the healthiest people in society, but sadly, they're still prone to risk factors when it comes to developing heart disease, particularly later in life. These can include:

• Diabetes
• High blood pressure
• High cholesterol

It's important to look at lifestyle choices as well like smoking, recreational drug use or performance-enhancing drugs which can also increase the risk of developing heart disease. Perhaps even more so later in life, it's very important to assess an individual's family history for genetic risk.

Do sportspeople run a higher risk of developing some health problems?

Athletic people represent the healthiest portion of our society. However, some rare heart conditions need to be screened for to ensure safety when exercising. These include heart muscle disorders such as cardiomyopathy, or electrical heart abnormalities such as ion channelopathy.

There is also some research suggesting that a small group of athletic individuals can develop coronary artery disease or heart rhythm problems such as atrial fibrillation as they get older. This requires evaluation and careful management.

However, the most important message to take home from this is that regular exercise and an active lifestyle have significant benefits for cardiovascular health, general health, mental health and well-being.

What can patients expect from their first sports cardiology consultation?

At your first sports cardiology consultation you can expect a detailed clinical evaluation with a history and examination that is specific and tailored to you. This will focus on relevant family history to assess for any increased genetic risk. We will talk in detail about your exercise regime including the type of exercise that you do, the frequency of this exercise and for how long you’ve been doing this amount of exercise.

We will also focus on lifestyle and social factors including smoking and alcohol intake. We will then talk through all the relevant investigations so that you understand what the tests are and what they’re for.

We'll make a personalized management plan together so that you'll able to lead a full and healthy lifestyle going forward.

Dr Navin Chandra is a renowned cardiologist based in Slough, London and Windsor. If you would like to book an appointment with Dr Chandra you can do so today via his Top Doctors profile.