EP299: CSANZ 23 - Athletes and SCA

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Podcast Summary Introduction Dr. Warrick Bishop, a cardiologist, author, and CEO of the Healthy Heart Network, hosts this episode to help people understand cardiovascular health and disease prevention. In this episode, Dr. Bishop synthesizes presentations from the 2023 Cardiac Society conference in Adelaide, covering sports cardiology and arrhythmia management, featuring insights from leading cardiologists including Adrian Elliott, André Laguerche, Chris Samsarian, and Liz Peretz. Key Takeaways: Endurance athletes, particularly men, face an increased risk of atrial fibrillation despite being highly fit, likely due to structural remodeling of the atria and changes in vagal tone from intense training. Athletes with atrial fibrillation respond well to pulmonary vein ablation, the same treatment used for non-athletic populations, though the increased stroke risk in athletes remains theoretically concerning despite lack of supporting studies. Endurance athletes show increased coronary artery calcium scores, which may result from wear and tear on arterial walls rather than dangerous plaque development, and the calcified plaques formed are typically more stable and less likely to cause heart attacks. Genetic testing is crucial for identifying cardiac disease in athletes, covering conditions like cardiomyopathy, arrhythmias, metabolic disorders, and congenital issues, but must follow key principles: establishing correct clinical phenotype, providing pre-test genetic counseling, and involving genetic cardiology experts. Sudden cardiac death in young people (under 35 years) is most commonly caused by coronary artery disease, not coronary artery anomalies as previously believed, challenging historical assumptions based on newer autopsy data. Drug toxicity is the second leading cause of sudden cardiac death in young people, highlighting the critical importance of improving society's use and understanding of drugs. Familial hypercholesterolemia is a significant risk factor for sudden cardiac death in young people and requires aggressive identification through family tracing, genetic testing, and early therapeutic intervention.