Should perform/prescribe:
"Athletes with ASCAD should undergo maximal exercise testing to evaluate exercise tolerance, the presence of inducible ischemia, and the presence of exercise-induced electrical instability. Testing should be performed on the subject’s standard medical regimen, including β-adrenergic blocking medications."
(Class I Recommendation; Level of Evidence C)
"Athletes with ASCAD should undergo an evaluation of left ventricular function."
(Class I Recommendation; Level of Evidence C)
All patients with ASCAD:
"Once informed of the results of the evaluations contained in recommendations 1 and 2, adult patients with ASCAD should participate in the decision as to whether the health and psychological benefits of exercise for them outweigh the risk."
(Class I Recommendation; Level of Evidence C)
"Athletes with ASCAD should undergo aggressive risk factor reduction with high-intensity statin therapy to reduce the chance of plaque disruption."
(Class I Recommendation; Level of Evidence A)
Clinically concealed ASCAD, LVEF >50%
"It is reasonable for athletes with clinically concealed ASCAD to participate in all competitive activities if their resting left ventricular ejection fraction is >50% and they have no inducible ischemia or electrical instability." (Recommendation 5)
(Class IIb Recommendation; Level of Evidence C)
Clinically manifest ASCAD, LVEF >50%, asymptomatic, no ischemia or electrical instability
"It is reasonable for patients with clinically manifest ASCAD to participate in all competitive activities if their resting left ventricular ejection fraction is >50%, they are asymptomatic, and they have no inducible ischemia or electrical instability." (Recommendation 6)
(Class IIb Recommendation; Level of Evidence C)
Clinically manifest ASCAD, not meet criteria
"It is reasonable to restrict patients with clinically manifest ASCAD that does not fulfill the criteria in recommendation 6 to sports with low dynamic and low to moderate static demands." (Recommendation 7)
(Class IIb Recommendation; Level of Evidence C)
Clinically manifest ASCAD, recent AMI or revascularization, worsening ischemia
"It is reasonable to prohibit patients with clinically manifest ASCAD from competitive sport participation:
(Class IIb Recommendation; Level of Evidence C)
Reference: Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 8: Coronary Artery Disease.
A Scientific Statement From the AHA and ACC. Circulation 2015
Disclaimer: This website is derived from published guidelines, but does not constitute medical advice nor does it replace clinical judgement. Only the text in quotation marks are direct quotations from the original guidelines. Text not in quotations as well as the method of information display are all that of the website creator and are not part of the original published guidelines. Please consult a physician to discuss any patient-specific matters.
Key: ASCAD = atherosclerotic coronary artery disease, LVEF = LV ejection fraction, AMI = acute myocardial infarction