Top medical, scientific and sports experts from the International Olympic Committee (IOC), and several International Federations (IFs) and National Olympic Committees (NOCs) met last week in Lausanne, Switzerland, for the 2nd IOC Course on Periodic Health Evaluation (PHE) and Imaging Testing to share medical know-how on cardiovascular diagnosis.
This one-day educational initiative, strongly supported and organised by the IOC, seeks to provide invaluable insight into the evolving technologies in imaging testing and cardiovascular screening, and the methods of assessing athletes’ risk profiles.
Sudden and unexpected cardiac death is a rare, but tragic and emotional event, which assumes a higher visibility when it occurs in an Olympic athlete. Consequently, it raises several medical and legal issues within the Olympic Movement, including the most appropriate strategy to prevent these catastrophes.
The IOC approached this issue in a dedicated report in 2009 entitled “Consensus Statement on periodic health evaluation of elite athletes” - whereby the rationale and methods for cardiovascular screening of elite athletes were extensively described.
For instance, the screening protocol, including the 12-lead electrocardiogram (ECG), as suggested in the IOC’s report, has the power to identify (or raise suspicion for) most of the cardiac disease at risk. This examination, however, may also show certain abnormalities in athletes which overlap with changes seen in patients with cardiomyopathies. Therefore, the ECG can raise uncertainty regarding the diagnosis and conveys the indication for additional testing, primarily imaging testing, such as echocardiography, to confirm or exclude the presence of a cardiovascular disease.
In recent years, the different imaging techniques (echocardiography, cardiac magnetic resonance, CT scan) have become widely available and have entered in the routine work-up of the cardiovascular diagnosis. Therefore, the knowledge for appropriate indication and expected results of these techniques has become an increasingly integrant part of medical know-how.
This educational course was then an opportunity to provide team doctors and sports specialist from several International Federations and National Olympic Committees with the most updated academic and practical information for appropriate indication and interpretation of imaging testing in the context of periodical health evaluation of elite athletes.