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Shared Decision Making for Athletes with Cardiovascular Disease

Practical Considerations

Baggish, Aaron L., MD, FACC, FACSM1; Ackerman, Michael J., MD, PhD2; Putukian, Margot, MD, FACSM3; Lampert, Rachel, MD4

Current Sports Medicine Reports: March 2019 - Volume 18 - Issue 3 - p 76–81
doi: 10.1249/JSR.0000000000000575
Chest and Abdominal Conditions/Section Article

The diagnosis and management of cardiovascular disease (CVD) in competitive athletes represent a fundamental responsibility of the sports medicine community. Following the diagnosis of a CVD in a competitive athlete, it is the responsibility of the sports medicine team to delineate an effective treatment and management strategy that places the health and wellness of the athlete as the primary objective. An essential and often challenging aspect of this process is determining the appropriateness of continued participation (i.e., “return-to-play”) in competitive athletics. Recently, a joint American Heart Association and American College of Cardiology Scientific Statement delineating sports eligibility supports a more patient-centered care model that supports shared decision making for clinicians and their patients/families. The present document was written to summarize the changing sports cardiology landscape with an aim of providing the cardiology and sports medicine communities with some practical approaches to eligibility decision making for competitive athletes with heart disease.

1Cardiovascular Performance Program, Cardiology Division, Massachusetts General Hospital, Boston, MA;

2Departments of Cardiovascular Medicine (Division of Heart Rhythm Services), Pediatric and Adolescent Medicine (Division of Pediatric Cardiology), and Molecular Pharmacology and Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN;

3University Health Services, Athletic Medicine, Princeton University, Princeton, NJ; and

4Cardiology/Internal Medicine, Yale School of Medicine, New Haven, CT

Address for correspondence: Aaron L. Baggish, MD, FACC, FACSM, Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit St, Boston, MA 02114; E-mail:

Copyright © 2019 by the American College of Sports Medicine.