Sports cardiology field as a key player in optimizing cardiovascular health during sports

Main Article Content

Mohammed Mohyeldin
https://orcid.org/0000-0003-3410-357X
Muhammad Reihan
https://orcid.org/0000-0002-3634-1777
Mohamed R. Herzalla
https://orcid.org/0000-0002-9617-7825
Husna Irfan Thalib
Ayesha Jamal
Fatma Ahmed
https://orcid.org/0009-0003-9623-971X
Eman Sobh
https://orcid.org/0000-0002-3458-8696

Abstract

Background: Sudden cardiac death (SCD) in athletes, though rare, continues to make headlines, raising questions about its underlying causes. Athletes are generally healthy, yet life-threatening cardiac events can occur unexpectedly in those without prior symptoms. Early detection of high-risk cardiac conditions is critical for prevention. Main text: Sports cardiology is an emerging specialty focused on the cardiovascular health of competitive athletes and highly active individuals, including those with known or undiagnosed heart disease. It encompasses structural, functional, and electrical cardiac assessment, exercise physiology, and preventive strategies. Screening and preparticipation evaluation are vital to identify hidden cardiovascular risks and differentiate physiological adaptations from pathology. This review highlights the importance of sports cardiology in optimizing cardiovascular performance, preventing SCD, and managing cardiovascular conditions such as arrhythmias, cardiomyopathies, coronary artery disease, and hypertension in physically active populations. Conclusions: Sports cardiology is rapidly evolving and plays a crucial role in safeguarding the health of athletes and active individuals. Optimal care requires an integrated approach, specialized knowledge, and targeted research initiatives to ensure safe participation in competitive and recreational exercise while minimizing cardiovascular risks.

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Review Paper

Author Biographies

Mohammed Mohyeldin, Al-Azhar University

Cardiology Department. Faculty of Medicine.

Muhammad Reihan, Al-Azhar University

Cardiology Department. Faculty of Medicine. Al-Azhar University.

Department of Medicine. General Medicine Practice Program. Batterjee Medical College.

Mohamed R. Herzalla, Zagazig University

Department of Internal Medicine. Faculty of Medicine. Zagazig University.

Department of Medicine. General Medicine Practice Program. Batterjee Medical College.

Husna Irfan Thalib, Batterjee Medical College

General Medicine Practice Program.

Ayesha Jamal, Batterjee Medical College

General Medicine Practice Program.

Fatma Ahmed, Badr University in Cairo

Faculty of Nursing.

Eman Sobh, Taibah University

Respiratory Therapy Department. College of Medical Rehabilitation Sciences. Taibah University.

Chest Diseases Department. Faculty of Medicine for Girls. Al-Azhar University.

How to Cite

Mohyeldin, M., Reihan, M., Herzalla, M. R., Thalib, H. I., Jamal, A., Ahmed, F., & Sobh, E. (2026). Sports cardiology field as a key player in optimizing cardiovascular health during sports. Journal of Human Sport and Exercise, 21(3), 994-1008. https://doi.org/10.55860/g0e11983

References

Abdelfattah, R. S., & Froelicher, V. F. (2015). Palpitations in athletes. Current Sports Medicine Reports, 14(5), 333-336. https://doi.org/10.1097/01.CSMR.0000466789.13643.f1

Aengevaeren, V. L., & Eijsvogels, T. M. H. (2020). Coronary atherosclerosis in middle-aged athletes: Current insights, burning questions, and future perspectives. Clinical Cardiology, 43(8), 863-871. https://doi.org/10.1002/clc.23340

Ahmadi, M. N., Gill, J. M. R., & Stamatakis, E. (2022). Association of changes in physical activity and adiposity with mortality and incidence of cardiovascular disease: Longitudinal findings from the UK Biobank. Mayo Clinic Proceedings, 97(5), 847-861. https://doi.org/10.1016/j.mayocp.2021.11.026

American Heart Association. (2021). Pre-participation cardiovascular screening of young competitive athletes: Policy guidance.

Baggish, A. L., Battle, R. W., Beckerman, J. G., Bove, A. A., Lampert, R. J., Levine, B. D., et al. (2017). The present and future sports cardiology core curriculum for providing cardiovascular care to competitive athletes and highly active people. Journal of the American College of Cardiology, 70(14), 1902-1918. https://doi.org/10.1016/j.jacc.2017.08.055

Baggish, A. L., & Wood, M. J. (2011). Athlete's heart and cardiovascular care of the athlete. Circulation, 123(23), 2723-2735. https://doi.org/10.1161/CIRCULATIONAHA.110.981571

Barker, K., & Eickmeyer, S. (2020). Therapeutic exercise. Medical Clinics of North America, 104(2), 189-198. https://doi.org/10.1016/j.mcna.2019.10.003

Borjesson, M., Dellborg, M., Niebauer, J., LaGerche, A., Schmied, C., Solberg, E. E., et al. (2019). Recommendations for participation in leisure time or competitive sports in athletes-patients with coronary artery disease. European Heart Journal, 40(1), 13-18. https://doi.org/10.1093/eurheartj/ehy408

Burtscher, J., Strasser, B., Burtscher, M., & Millet, G. P. (2022). The impact of training on the loss of cardiorespiratory fitness in aging master's endurance athletes. International Journal of Environmental Research and Public Health, 19, 11050. https://doi.org/10.3390/ijerph191711050

Carlsen, K.-H. (2012). Mechanisms of asthma development in elite athletes. Breathe, 8(4), 278-284. https://doi.org/10.1183/20734735.009512

Colivicchi, F., Ammirati, F., & Santini, M. (2004). Epidemiology and prognostic implications of syncope in young competing athletes. European Heart Journal, 25(20), 1749-1753. https://doi.org/10.1016/j.ehj.2004.07.011

Corrado, D., Pelliccia, A., Heidbuchel, H., Sharma, S., Link, M., Basso, C., et al. (2010). Recommendations for interpretation of 12-lead electrocardiogram in the athlete. European Heart Journal, 31(2), 243-259. https://doi.org/10.1093/eurheartj/ehp473

Dawes, T. J. W., Corden, B., Cotter, S., de Marvao, A., Walsh, R., Ware, J. S., et al. (2016). Moderate physical activity in healthy adults is associated with cardiac remodeling. Circulation: Cardiovascular Imaging, 9(12). https://doi.org/10.1161/CIRCIMAGING.116.004712

Deichmann, R. E., Lavie, C. J., Asher, T., DiNicolantonio, J. J., O'Keefe, J. H., & Thompson, P. D. (n.d.). The interaction between statins and exercise: Mechanisms and strategies to counter musculoskeletal side effects.

Dickie, K. E., & Terblanche, E. (2020). Behavioural lifestyle factors, physical health-related fitness and cardiometabolic disease risk in women from a low socio-economic urban community in Stellenbosch (Western Cape). [Unpublished manuscript].

Dores, H., de Araújo Gonçalves, P., Cardim, N., & Neuparth, N. (2018). Coronary artery disease in athletes: An adverse effect of intense exercise? Revista Portuguesa de Cardiologia, 37(1), 77-85. https://doi.org/10.1016/j.repc.2017.06.006

Finch, J. A. M., & Baggish, A. L. (2016). Cardiovascular evaluation and treatment of the endurance athlete. In Endurance sports medicine (pp. 3-19). Springer. https://doi.org/10.1007/978-3-319-32982-6_1

García-Sánchez, E., Rubio-Arias, J. Á., Ávila-Gandía, V., López-Román, F. J., & Menarguez-Puche, J. F. (2020). Effects of two community-based exercise programs on adherence, cardiometabolic markers, and body composition in older people with cardiovascular risk factors: A prospective observational cohort study. Journal of Personalized Medicine, 10(4), 176. https://doi.org/10.3390/jpm10040176

Gibson, A. L., Wagner, D., & Heyward, V. (2019). Advanced fitness assessment and exercise prescription (8th ed.). Human Kinetics. https://doi.org/10.5040/9781718220966

Gleason, P. T., & Kim, J. H. (2017). Exercise and competitive sport: Physiology, adaptations, and uncertain long-term risks. Current Treatment Options in Cardiovascular Medicine, 19(9), 79. https://doi.org/10.1007/s11936-017-0578-7

Gluckman, T. J., Bhave, N. M., Allen, L. A., Chung, E. H., Spatz, E. S., Ammirati, E., et al. (2022). 2022 ACC expert consensus decision pathway on cardiovascular sequelae of COVID-19 in adults. Journal of the American College of Cardiology, 79(17), 1717-1756. https://doi.org/10.1016/j.jacc.2022.02.003

Gulati, M., Levy, P. D., Mukherjee, D., Amsterdam, E., Bhatt, D. L., Birtcher, K. K., et al. (2021). 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for chest pain evaluation. Journal of the American College of Cardiology, 78(22), e187-e285. https://doi.org/10.1016/j.jacc.2021.07.053

Halliwill, J. R., Buck, T. M., Lacewell, A. N., & Romero, S. A. (2013). Postexercise hypotension and sustained postexercise vasodilatation: What happens after we exercise? Experimental Physiology, 98(1), 7-18. https://doi.org/10.1113/expphysiol.2011.058065

Han, J., Lalario, A., Merro, E., Sinagra, G., Sharma, S., Papadakis, M., et al. (2023). Sudden cardiac death in athletes: Facts and fallacies. Journal of Cardiovascular Development and Disease, 10(2), 68. https://doi.org/10.3390/jcdd10020068

Hindricks, G., Potpara, T., Dagres, N., Arbelo, E., Bax, J. J., Blomström-Lundqvist, C., et al. (2021). 2020 ESC guidelines for atrial fibrillation. European Heart Journal, 42(5), 373-498. https://doi.org/10.1093/eurheartj/ehaa612

Hosenpud, J. D., Campbell, S. M., Niles, N. R., Lee, J., Mendelson, D., & Hart, M. V. (1987). Exercise-induced autoimmunity in myocarditis. Cardiovascular Research, 21(3), 217-222. https://doi.org/10.1093/cvr/21.3.217

Hurwitz, B., & Issa, O. (2020). Management and treatment of myocarditis in athletes. Current Treatment Options in Cardiovascular Medicine, 22, 65. https://doi.org/10.1007/s11936-020-00875-1

Ito, S. (2022). High-intensity interval training for older adults: Safety issues. European Journal of Medical and Health Sciences, 4(1), 3-5. https://doi.org/10.24018/ejmed.2022.4.1.1224

Karam, N., Pechmajou, L., Narayanan, K., Bougouin, W., Sharifzadehgan, A., Anys, S., et al. (2022). Sports-related sudden cardiac arrest outcomes. Journal of the American College of Cardiology, 79(3), 238-246. https://doi.org/10.1016/j.jacc.2021.11.011

Katsi, V., Soulaidopoulos, S., Aggeli, C., Latsios, G., Tousoulis, D., & Toutouzas, K. (2021). Extensive coronary artery disease in a long-distance athlete. Journal of Athletic Training, 56(11), 1137-1141. https://doi.org/10.4085/JAT0330-20

Lampert, R., Ackerman, M. J., Marino, B. S., Burg, M., Ainsworth, B., Salberg, L., et al. (2023). Vigorous exercise in hypertrophic cardiomyopathy. JAMA Cardiology, 8(6), 595-603. https://doi.org/10.1001/jamacardio.2023.1042

Livingston, L., Forbes, S. L., Wattie, N., & Cunningham, I. (2020). Sport officiating: Recruitment, development, and retention. Routledge. https://doi.org/10.4324/9780429465291

MacLachlan, H., & Drezner, J. A. (2020). Risk-based cardiac evaluation of young athletes. Clinical Cardiology, 43(9), 906-914. https://doi.org/10.1002/clc.23364

Mancia, G., Kreutz, R., Brunström, M., Burnier, M., Grassi, G., Januszewicz, A., et al. (2023). 2023 ESH hypertension guidelines. Journal of Hypertension, 41(12), 1874-2071. https://doi.org/10.1097/HJH.0000000000003480

Maron, B. J., Doerer, J. J., Haas, T. S., Tierney, D. M., & Mueller, F. O. (2009). Sudden deaths in athletes. Circulation, 119(8), 1085-1092. https://doi.org/10.1161/CIRCULATIONAHA.108.804617

Maron, B. J., Thompson, P. D., Puffer, J. C., McGrew, C. A., Strong, W. B., Douglas, P. S., et al. (1996). Preparticipation screening. Circulation, 94(4), 850-856. https://doi.org/10.1161/01.CIR.94.4.850

McDiarmid, A. K., Swoboda, P. P., Erhayiem, B., Lancaster, R. E., Lyall, G. K., Broadbent, D. A., et al. (2016). Athletic cardiac adaptation. Circulation: Cardiovascular Imaging, 9(12), e003579. https://doi.org/10.1161/CIRCIMAGING.115.003579

Mora, S., Cook, N., Buring, J. E., Ridker, P. M., & Lee, I.-M. (2007). Physical activity and cardiovascular risk. Circulation, 116(19), 2110-2118. https://doi.org/10.1161/CIRCULATIONAHA.107.729939

Newman, W., Parry-Williams, G., Wiles, J., Edwards, J., Hulbert, S., Kipourou, K., et al. (2021). Atrial fibrillation in athletes meta-analysis. British Journal of Sports Medicine, 55(21), 1233-1238. https://doi.org/10.1136/bjsports-2021-103994

Ora, J., De Marco, P., Gabriele, M., Cazzola, M., & Rogliani, P. (2024). Exercise-induced asthma. Journal of Functional Morphology and Kinesiology, 9(1), 15. https://doi.org/10.3390/jfmk9010015

Paquette, M. R., Napier, C., Willy, R. W., & Stellingwerff, T. (2020). Training load quantification. Journal of Orthopaedic & Sports Physical Therapy, 50(10), 564-569. https://doi.org/10.2519/jospt.2020.9533

Pescatello, L. S., MacDonald, H. V., Ash, G. I., Lamberti, L. M., Farquhar, W. B., Arena, R., et al. (2015). Hypertension exercise recommendations. Mayo Clinic Proceedings, 90(6), 801-812. https://doi.org/10.1016/j.mayocp.2015.04.008

Petek, B. J., & Baggish, A. L. (2020). Pre-participation screening controversies. Expert Review of Cardiovascular Therapy, 18(7-8), 435-442. https://doi.org/10.1080/14779072.2020.1787154

Pyne, D. B. (1994). Neutrophil function during exercise. Sports Medicine, 17(4), 245-258. https://doi.org/10.2165/00007256-199417040-00005

Rajendran, A. J., George, P., Srichandran, L., & Vijayashree, N. (2023). Cardiovascular rehabilitation. In Cardiovascular and kidney disease within the geriatric population in developing countries (pp. 243-267).

Rao, P., & Shipon, D. M. (2019). Atrial fibrillation in athletes. American College of Cardiology.

Refoyo, E., Troya, J., de la Fuente, A., Beltrán, A., Celada, O. L., Díaz-González, L., et al. (2023). Myocardial work index in football players. Journal of Clinical Medicine, 12(9), 3059. https://doi.org/10.3390/jcm12093059

Reissig, C. J., Strain, E. C., & Griffiths, R. R. (2009). Energy drinks problem. Drug and Alcohol Dependence, 99(1-3), 1-10. https://doi.org/10.1016/j.drugalcdep.2008.08.001

Scharhag, J., Schneider, G., Urhausen, A., Rochette, V., Kramann, B., & Kindermann, W. (2002). Athlete's heart. Journal of the American College of Cardiology, 40(10), 1856-1863. https://doi.org/10.1016/S0735-1097(02)02478-6

Schweiger, V., Niederseer, D., Schmied, C., Attenhofer Jost, C., & Caselli, S. (2021). Athletes and hypertension. Current Cardiology Reports, 23, 176. https://doi.org/10.1007/s11886-021-01608-x

Siegel, A. J. (2023). Marathon aspirin prevention. American Journal of Medicine, 136(5), 613-615. https://doi.org/10.1016/j.amjmed.2023.02.007

Sobh, E., Reihan, M. S., Hifnawy, T. M. S., Abdelsalam, K. G., Awad, S. S., Mahmoud, N. M. H., et al. (2021). COVID-19 cardiovascular effects. The Egyptian Heart Journal, 73, 77. https://doi.org/10.1186/s43044-021-00202-4

Stöhr, E. J., & Pugh, C. J. A. (2021). Endurance athlete circulation. Atherosclerosis, 320, 89-91. https://doi.org/10.1016/j.atherosclerosis.2021.01.019

Tanasescu, M. (2002). Exercise and coronary heart disease. JAMA, 288(16), 1994-2000. https://doi.org/10.1001/jama.288.16.1994

Teyhen, D. S., Shaffer, S. W., Goffar, S. L., Kiesel, K., Butler, R. J., Rhon, D. I., et al. (2020). Injury risk factors in athletes. Sports Health, 12(6), 564-572. https://doi.org/10.1177/1941738120902991

Troiano, R. P. (2023). Physical activity accelerometers. Journal of Measurement in Physical Behaviour, 6(1), 13-18. https://doi.org/10.1123/jmpb.2022-0038

U.S. Department of Health and Human Services. (2008). Physical activity guidelines for Americans.

van Hattum, J. C., Verwijs, S. M., Senden, P. J., Spies, J. L., Boekholdt, S. M., Groenink, M., et al. (2022). Sports cardiology team approach. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 6(5), 525-535. https://doi.org/10.1016/j.mayocpiqo.2022.08.006

Weizman, O., Empana, J.-P., Blom, M., Tan, H. L., Jonsson, M., Narayanan, K., et al. (2023). Cardiac arrest in women sports. Journal of the American College of Cardiology, 81(10), 1021-1031. https://doi.org/10.1016/j.jacc.2023.01.015

Wilhelm, M. (2014). Atrial fibrillation in endurance athletes. European Journal of Preventive Cardiology, 21(8), 1040-1048. https://doi.org/10.1177/2047487313476414

Williams, R. P., Manou-Stathopoulou, V., Redwood, S. R., & Marber, M. S. (2014). Warm-up angina. Heart, 100(2), 106-114. https://doi.org/10.1136/heartjnl-2013-304187

Zelenović, M., Božić, D., Aksović, N., Iacob, G. S., Alempijević, R., & Bjelica, B. (2021). Physical activity and mortality. International Journal of Sport Culture and Science, 9(3), 255-267.

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