Sports and Exercise Cardiology Highlights From the American Heart Association Scientific Sessions 2025

A central sports activities cardiology session at the 2025 American Heart Association (AHA) Scientific Sessions, titled “Competitive Sports Participation for Athletes with Heart Disease: New Guidance and Future Directions,” highlighted main updates from the 2025 AHA/American College of Cardiology (ACC) scientific statement on Clinical Considerations for Competitive Sports Participation for Athletes With Cardiovascular Abnormalities.¹

2025 AHA/ACC Scientific Statement: Rationale and Key Highlights

Dr. Jonathan Kim, present chair of the ACC Sports and Exercise Cardiology Member Section, outlined the motivation behind the new scientific assertion, which gives a up to date scientific strategy that includes advances in threat evaluation, shared decision-making, genetic analysis, imaging, and longitudinal monitoring. Among the driving forces that prompted the up to date suggestions included the emergence of latest knowledge on the dangers of adversarial cardiac occasions in athletes with cardiac circumstances (e.g., genetic cardiomyopathies, lengthy QT syndrome). Three sections obtained explicit emphasis:

• Section III: Ethical Aspects of Competitive Sports Eligibility. This part emphasizes a shift away from a paternalistic strategy towards respecting athlete autonomy. Key factors embody speaking evidence-based threat and uncertainty and participating athletes in a shared decision-making course of with applicable subspecialty involvement.
• Section X: Masters Athletes. Defined as individuals ≥35 years of age who place a excessive premium on aggressive sports activities participation, masters athletes have distinctive age-related cardiovascular concerns. The scientific assertion discusses coronary illness, atrial fibrillation, myocardial fibrosis, aortic dilation or aneurysm, and continual valvular coronary heart illness on this inhabitants.
• Section XI: Additional Cardiac Conditions and Considerations. This part covers pulmonary embolism, hypertension, commotio cordis, train in excessive environments (e.g., excessive altitude and leisure scuba), and being pregnant in aggressive athletes.

Shared Decision-Making With Athletes: An Ethical Imperative

Dr. Rachel Lampert bolstered the moral crucial of shared decision-making with athletes. Traditional common restriction or disqualification now not meets fashionable requirements, and athletes have to be handled as knowledgeable companions in threat discussions with choices revisited over time.

Genetic Cardiomyopathies and Competitive Sports: No Longer Universal Disqualifications

Dr. Matthew Martinez detailed up to date approaches to managing athletes with genetic cardiomyopathies. Supported by rising proof together with a cohort of 1,660 sufferers with hypertrophic cardiomyopathy participating in vigorous train,² uniform restriction or disqualification shouldn’t be utilized to aggressive athletes with cardiomyopathies. Risk stratification is crucial and ought to incorporate imaging (significantly cardiac magnetic resonance imaging), rhythm monitoring, and extra disease-specific skilled opinions when wanted.

Preparticipation Cardiac Evaluation: What Practitioners Need to Know in 2025

Incoming chair of the ACC Sports and Exercise Cardiology Member Section, Dr. Ankit Shah, emphasised the central function of the AHA 14-point historical past and bodily examination in the preparticipation analysis (Image 1). Dr. Shah additionally mentioned the significance of emergency motion plans with a give attention to automated exterior defibrillator availability and accessibility. Routine cardiac imaging, ambulatory monitoring, and stress testing will not be really helpful for screening. Electrocardiogram (ECG) screening is affordable when interpreted by clinicians educated in athlete-specific ECG standards and supported by systematic processes for applicable downstream analysis. Widespread obligatory ECG screening is just not really helpful.

Image 1

Dr. Ankit Shah offered updates to the preparticipation cardiac analysis suggestions with an emphasis on evidence-based approaches to screening.

Outcomes Registry for Cardiac Conditions in Athletes: The Path Forward

Dr. Bradley Petek described the ORCCA (Outcomes Registry for Cardiac Conditions in Athletes), which screens outcomes in athletes with probably life-threatening cardiac circumstances (Image 2).³ Dr. Petek highlighted the ease of enrolling sufferers, which will be accomplished in

Image 2

Dr. Bradley Petek offered details about the ORCCA and urged clinicians caring for athletes with CV circumstances to take part.
CV = cardiovascular; ORCCA = Outcomes Registry for Cardiac Conditions in Athletes.

Athletes and suppliers fascinated with collaborating in the ORCCA can discover extra data and registration supplies on the examine’s web site.⁴

For these fascinated with studying extra about the up to date pointers and how one can greatest put them into motion, there might be an ACC Care of the Athletic Heart preconference at ACC.26 in New Orleans, Louisiana. The preconference will happen on Friday, March 27, 2026 at the convention middle.

References

1. Kim JH, Baggish AL, Levine BD, et al. Clinical concerns for aggressive sports activities participation for athletes with cardiovascular abnormalities: a scientific assertion from the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2025;85(10):1059-1108. doi:10.1016/j.jacc.2024.12.025
2. Lampert R, Ackerman MJ, Marino BS, et al. Vigorous train in sufferers with hypertrophic cardiomyopathy. JAMA Cardiol. 2023;8(6):595-605. doi:10.1001/jamacardio.2023.1042
3. Moulson N, Petek BJ, Ackerman MJ, et al. Rationale and design of the ORCCA (Outcomes Registry for Cardiac Conditions in Athletes) examine. J Am Heart Assoc. 2023;12(11):e029052. doi:10.1161/JAHA.122.029052
4. Outcomes Registry for Cardiac Conditions in Athletes (ORCCA). Register With ORCCA: Join the Study (ORCCA web site). 2022. Available at: https://orccastudy.org/. Accessed 01/26/2026.