What is Sports Cardiology?

Podcast Transcript

Announcer:

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Tamanna Singh, MD:

Hi everybody. I'm Dr. Tamanna Singh. I'm one of the co-directors of our Sports Cardiology Center here at the main campus at Cleveland Clinic.

Michael Emery, MD:

And I'm Dr. Michael Emery. I'm also one of the co-directors with Dr. Singh for the Sports Cardiology Center.

Tamanna Singh, MD:

And we're here today to talk to you about some of the services that we can offer. But I guess before we get started there, Mike, can you tell us a little bit about what is sports cardiology?

Michael Emery, MD:

Yeah, so sports cardiology is really about care of the competitive athlete and highly active person. So we really see patients across the age, spectrum and fitness spectrum for that regards, right? We see high school athletes all the way up to master’s athletes, whether they're professional, recreational collegiate high school, really across the spectrum.

Tamanna Singh, MD:

And I think when we say master's athletes, for some of you who may not know that refers to our... you know, age is just a number, I guess we can say… but our athletes are typically above the age of 40. So we really see anybody who's trying to maintain an active lifestyle. And I think Mike you'd probably agree with me here, one of the most important things is understanding that sometimes people who are pretty active coming with unique situations that require a unique, I guess, point of view, with respect to their cardiovascular care, what do you think?

Michael Emery, MD:

Yeah, we really do a lot of trying to understand the physiology of that athlete, not only what they're going through, but the physiology of their sport and how that could impact their cardiovascular system. Sometimes that gets into what we call the gray zone of the athlete's heart. So that means that the cardiovascular changes that happen to allow you to be a great athlete, can sometimes, in isolation, look abnormal when they're really not abnormal. But occasionally it may be abnormal and it takes some nuance and some real understanding of exercise physiology, human performance, and the cardiovascular system to tease those things out.

Tamanna Singh, MD:

And I think that's where Mike and I come in. As trained sports cardiologists, it's really important for us to be able to be an advocate for our patient athletes and to be mindful of these gray zone situations where it's quite possible you might see a provider who is giving you advice based upon what they typically tell someone who's not as active, but for us that advice may not be applicable to you. And sometimes we run into situations where people are told they can't exercise. And fortunately, we're able to tell them that they can. Of course, it's always important to note that athletes are not immune to cardiovascular issues. And we're very transparent about that, but we also recognize that being active is certainly something that contributes to our active patient's quality of life. So we really try to do our best to align with our patient athletes, really make sure we're treating them appropriately, whether that be liberalizing exercise and activity or not.

Michael Emery, MD:

Yeah, I think, as you highlight a lot of what we end up talking to patients about is how they can exercise safely, particularly with cardiac disease. If you've had a prior stent or a heart attack or a heart surgery, or you have some genetically inherited condition, we're sort of at the forefront of trying to provide a safe exercise prescription, risk stratification, and an element of what we call shared decision-making. So we can both participate in the decision to continue or not continue to exercise and what those risks may be. There are a lot of, I think, fallacies about what you can and can't do. And a lot of fear that we try to assuage in some regards and put in the right perspective.

Tamanna Singh, MD:

And that's an excellent point. I think we try to do our due diligence in terms of making sure that we are safe in our recommendations. But like we're alluding to, I think we're kind of a special quality, a special team of cardiologists that can really be helpful to individuals who want to be active, who want to make sure they're healthy from a heart perspective and who perhaps maybe have some cardiovascular conditions that we can guide them through. And the cool thing about our field is that it's always changing. And fortunately, I find that it's changing for the better, with respect to us being able to have people be able to do more activity than previously thought. So I think that's probably one of the coolest things I like about our field. Mike, what about you?

Michael Emery, MD:

Yeah. It's sort of exploding in terms of the knowledge that we're continuing to gain and getting away from this paternalistic or telling you what you can and can't do and helping you understand who you are and you as an individual athlete. I think we approach every athlete as an individual person and an individual test of their own physiology and not try to lump you together with everybody else, if you will.

Tamanna Singh, MD:

Yep. And we've got now professional players who've got heart problems who are safe to play. We've got high school and collegiate athletes who may come in with heart issues that are safe to play, sometimes in people who got genetic or family problems that we always want to take into account when we're assessing their ability to play. So I would say that the forefront is ever-changing and we're really excited to be a part of this field.

Michael Emery, MD:

Yeah. And I think one of the misconceptions we ought to address too, is that you don't have to be a quote "professional athlete" to come see us. While that sounds impressive. It's very, very small part of what we do, seeing professional athletes. The vast majority of what we see are recreational athletes that are doing 5Ks, 10Ks, marathons, triathlons, CrossFit who have concerns about cardiac disease or have real cardiac disease, or don't understand recommendations about exercise from other physicians. That's really the bread and butter of what we do and probably what we enjoy the most. Because it's where we can provide the most input and the most education.

Tamanna Singh, MD:

Okay. Mike, I know our audience wonders. What do you like to do? What's your favorite activities?

Michael Emery, MD:

I'm a CrossFit addict, if you will. I've been doing that for almost 10 years, have my certification. And I bring a lot of the experience from CrossFit to how I counsel patients as well. So what about you?

Tamanna Singh, MD:

I love to run. I always joke that when I went into sports cardiology one of my mentors said make sure you bring a pair of running shoes. And I did. I laughed at it and never thought I'd do more than a 5k, but now I really enjoy some of the longer distances in marathons. And Mike, you said it right. I mean, I think our experience in athletics, even from a recreational perspective, allows us to give a different type of lens to our patients. We understand what their goals may be. We understand some of the limitations that they might find, and we really do try to be our patient’s advocate as best as we can. So definitely come and see us. There are multiple ways to get in touch with us. We've got a great website, a contact number and an email. We're always available to answer questions and to see patients nationwide, globally. However far we can.

Michael Emery, MD:

Exactly. Happy to help.

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