Sports Cardiology - Specialists and Information

Sports cardiology is a medical specialty that focuses on heart health and sports medicine. This specialty examines the holistic effects of physical activity on the human body.

Doctors in this field pay particular attention to:

• Heart
• Blood vessels
• Metabolism and 
• mental well-being

Sports cardiology deals with the effects of physical activity and sports on the cardiovascular system @ serafino /AdobeStock

As has been confirmed time and again, sports and physical activity often play an important role in the prevention and treatment of various medical conditions.

With targeted training programs, it is possible to support the cardiovascular system from a sports cardiology perspective. But whether you’re a recreational or professional athlete, you need sports cardiology-based preventive care with appropriate screening exams.

This helps you prevent potential cardiac events (sudden cardiac death). As such, the field of sports cardiology is quite comprehensive and cannot always be clearly distinguished from other areas of medicine.

The cardiovascular system includes the pulmonary circulation, through which oxygen-depleted blood is reoxygenated.

It also encompasses the systemic circulation, which pumps oxygen-rich blood throughout the body and later returns it to the pulmonary circulation.

All symptoms that fall within this scope are relevant to sports cardiology.

Examples include:

• Circulatory disorders in the arms, legs, and brain
• Heart failure
• Heart attack
• Fluid accumulation in the lungs (pulmonary edema),
• Venous disorders (e.g., thrombosis)
• Related conditions

Sports cardiology covers a broad spectrum of areas, ranging from healthy recreational athletes to patients with heart disease.

Doctors often develop personalized exercise plans designed to produce positive outcomes for patients with medical conditions and symptoms.

The following patient groups most commonly seek sports cardiology examinations, counseling, and treatment:

• People who want a checkup before starting or resuming a physical activity
• Recreational athletes with pre-existing or newly developed heart, lung, or vascular problems
• Children and adolescents who may have a heart, lung, or vascular condition
• Extreme athletes, such as divers or mountaineers
• Competitive athletes who come in for regular checkups

The following individuals should undergo a sports cardiology examination before starting a new sport:

• People with high blood pressure (hypertension)
• People with diabetes (Type 1 or Type 2) or
• People with abnormally high cholesterol levels

Even if you or a close relative already has a known cardiovascular condition, regular checkups with a sports cardiologist are recommended.

These checkups will give you the assurance that the intensity of your exercise and the type of sport you choose are appropriate for your health condition.

If you experience heart problems (chest pain, irregular heartbeat, or palpitations), shortness of breath, dizziness, or fainting during exercise, a sports cardiologist is the right person to consult.

A sports cardiologist performs tests that assess the function of the heart, lungs, and vascular system.

These include, among others:

• Spiroergometry (“Spiro”)
• Electrocardiogram (ECG)
• Echocardiography (“heart echo”)
• Magnetic resonance imaging of the heart (cardiac MRI)

These tests can be performed at rest. However, they are often followed by a stress test. Various devices are available for these so-called stress or exercise tests.

Conventional stress tests typically use a stationary bike and a treadmill. Sometimes a rowing machine is also used.

The purpose of these devices is to assess physical performance from a sports cardiology perspective. This allows the patient to identify risk factors in advance and avoid them after receiving detailed counseling.

Male athlete performing a cardiac stress test @ AH! Studio /AdobeStock

Spiroergometry: Using spiroergometry, the physician can measure oxygen uptake and carbon dioxide output during exercise and identify any abnormalities.

Resting ECG: To detect notable changes in the resting ECG of athletes, a so-called athlete’s ECG is often performed.

This allows the sports cardiologist to determine whether the patient suffers from the following conditions as a result of many years of intensive training:

• An enlarged heart (“athlete’s heart”)
• Cardiomyopathy (heart muscle disease) or
• Previously undiagnosed heart rhythm disorders

Stress ECG: Using a stress ECG, the sports cardiologist determines your performance limits and assesses your cardiac and circulatory functions. 

This is done using a stationary bike or treadmill with various, individually adjustable exercise levels. At the same time, the exercise electrocardiogram records how your heart responds to this exertion.

Echocardiography: Echocardiography is primarily used in competitive sports. To distinguish between exercise-induced and pathological changes in the heart, doctors measure:

• the left atrium
• the heart valves
• the pericardium, and
• the aorta

Cardiac MRI: Cardiac magnetic resonance imaging is an imaging technique that visualizes the following:

• the structure of the heart
• Condition of the heart chambers
• Possible physical abnormalities of the heart muscle

You can ask your health insurance provider or the Association of Statutory Health Insurance Physicians for a list of specialists in your area.

However, specialized clinics and hospital departments are also recommended for examinations in this field. Often, these facilities even have a wider range of diagnostic equipment that isn’t available to a private sports medicine physician.

If possible, seek advice by phone in advance. This is because the appropriate tests vary from case to case.

Depending on your age, the symptoms you’re experiencing, and the specific physical demands you face, the recommendation may vary.