This post was authored by Christina Salazar, MD, FACC, member of the ACC’s Sports and Exercise Cardiology Section Leadership Council.

Preparation and performance come to mind as I reflect on my experience as a first time faculty at ACC.15 in San Diego. I had the pleasure of co-chairing one of the four parts of the Sports and Exercise Intensive during ACC.15. It was not a difficult position, but exciting and I was able to meet and interact with several of the leading cardiologists in the field of sports cardiology.

This year’s Annual Scientific Session brought much excitement due to the focus on interactive education. For those of you who attended ACC.15, you were able to experience first-hand the many beneficial educational changes that were visible throughout the conference. In particular, the Sports and Exercise Intensive was a 4.25-hour block of time dedicated specifically to the growing field of sports cardiology. We were fortunate to have many leading cardiologists present during this intensive and in the end there were several take away points.

My experience as an early career and first time faculty was intensified with the Audience Response System. During the Sports and Exercise Intensive, audience members were able to submit live questions via their mobile devices and then vote as the session continued. As a moderator I was able to see the “most popular” questions and ensure that these questions were answered. This innovative way for the audience to interact was new and successful as it kept participants engaged.

The four parts of the Intensive included an interactive overview by Dr. Paul Thompson, one of the pioneering leaders in the field. He reflected on 35 years of Sports Cardiology with several take home points, which included a warning about “diagnostic creep.” In the field of sports cardiology this can be a common concern especially when athletes present with symptoms such as momentary chest discomfort that is very unlikely pathologic. These situations may lead to unnecessary testing. But, as I listened to him warn against unnecessary or too much testing, diagnostic creep, I thought of my daily clinical practice as a general non-invasive cardiologist. This is good advice for all of us, not just those of us in sports cardiology.

This was followed by an update on the guidelines for competitive athletes by Dr. Barry Maron. He also reflected on his experience as a sports cardiologist and noted that when he started people did not understand the causes of sudden cardiac death in athletes and some did not believe that cardiovascular abnormalities existed in athletes. Since then there have been three iterations of the Bethesda Guidelines which provide sports cardiologists and other physicians involved in the care of competitive athletes insight on eligibility and disqualification recommendations. We anxiously await the next set of guidelines hopefully to be released this year with several updates on things like “Can my athlete play X sport with a defibrillator?” Importantly, we must realize that these are guidelines and that the evidence in many areas of sports cardiology is not as robust as in many other areas of cardiology.

As Dr. Richard Kovacs pointed out, there is an ever-changing landscape in sports cardiology with involvement of many parties beyond cardiologists and physicians. This may include regulatory law on the state and federal level as well as involvement of professional sports teams and many different advocacy groups, which are often started by teammates, friends and family of an athlete who suffered sudden cardiac death.

This led us into several interesting sports cardiology cases as well as a part on imaging in the athlete. A few take-home points included the importance of understanding how the heart adapts to specific types of exercise as this affects the “normal” on all of our imaging modalities. Establishing a “normal” in athletes is ongoing. Secondly, when selecting a stress test as a diagnostic test of choice the athletes’ fitness and type of exercise must be taken into account to adequately stress the athlete.

The time sped by with 4.25 hours to reflect, learn and innovate in the field of sports cardiology. This was not enough time to learn everything, but it was a start. As a member of the Sports and Exercise Cardiology Council I look forward to more exciting opportunities. Lastly, I hope as a Council we are able to broaden our reach so that further collaborations across disciplines can increase knowledge in sports cardiology and continue to provide practical and clinical guidance to all those providers who care for athletes.

This post is part of a series of posts from the ACC’s Sports and Exercise Cardiology Section. Follow the sports and exercise cardiology conversation on Twitter with the hashtag #SportsCardio. Sign up for the “Sports and Exercise Cardiology” email digests on ACC.org for the latest sports and exercise hot topics.

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