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Cardiology uniquely integrates exercise in both the diagnosis and treatment of heart diseases. While exercise's impact on cardiovascular health has long been recognized, sports cardiology is a newer sub-specialty focused on athletes and exercise enthusiasts. Key concerns include detecting structural heart disease and managing arrhythmias to prevent sudden cardiac death and cardiovascular decline. Pre-participation screening for athletes has been a central debate in recent years. This commentary highlights current trends in sports cardiology and points to unresolved issues that will likely shape future developments.
Procedures for abnormal heart rhythms:
Catheter Ablation: This procedure uses radiofrequency energy or freezing to eliminate areas in the heart causing abnormal rhythms. It is guided by an electrophysiology study that maps the heart's electrical activity and can diagnose and treat abnormal rhythms.
Permanent Pacemaker: A pacemaker is implanted in the chest, connected to the heart via wires, and helps regulate a slow heartbeat by providing a consistent rhythm.
Implantable Cardioverter Defibrillator (ICD): A defibrillator wire is connected to a chest-implanted device that can pace or shock the heart back to normal rhythm, potentially lifesaving during dangerous heart rhythms.
Procedures for heart disease:
Cardiac Catheterization: A thin tube (catheter) is inserted into the heart through a blood vessel in the leg or arm to measure heart pressures and inject contrast dye for X-rays. This helps identify structural issues and artery blockages.
Percutaneous Coronary Intervention (PCI): A group of procedures to improve blood flow in coronary arteries.
Balloon Angioplasty (PTCA): A balloon is inflated inside a blocked artery to restore blood flow, often with a stent.
Coronary Artery Stent: A mesh coil is placed in the artery to keep it open.
Laser Angioplasty: A laser is used to open a blocked artery.
Atherectomy: A catheter shaves away the blocked area in the artery.
Coronary Artery Bypass Graft (CABG): Bypass surgery reroutes blood flow around blocked arteries using healthy blood vessels from other parts of the body, often the leg or chest.
Minimally Invasive CABG: A less invasive alternative to traditional bypass surgery using small incisions and video guidance.
Intra-Aortic Balloon Pump (IABP): A balloon device helps the heart pump more efficiently by improving blood flow and oxygen delivery to the heart muscle.
Ventricular Assist Device (VAD): A mechanical device that helps the heart pump blood when heart failure progresses or while awaiting a heart transplant.
Heart Transplant: Replaces a severely damaged heart with a donor heart when other treatments are no longer effective.
Procedures for valve disease:
Valvuloplasty: A balloon-tipped catheter is used to widen a narrowed heart valve. The catheter is guided through an artery to the heart, where the balloon is inflated to open the valve, then deflated and removed.
Valve Repair: Surgery to fix a damaged valve by either loosening stiff valve leaflets or tightening loose ones to restore proper function.
Valve Replacement: A damaged valve is replaced with a mechanical or tissue valve, often through open-heart surgery. For aortic valve stenosis, a less invasive procedure called TAVR (Transcatheter Aortic Valve Replacement) may be used to insert a new valve without open-heart surgery.
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