The Shared Decision Making Approach (SDM) represents a paradigm shift in clinical management, acknowledging the complexities and uncertainties in clinical medicine, while respecting the personal values and preferences of an informed, individual patient. The SDM approach is highly suitable to the screening and management of athletes, given the variable evidence, uncertainty as to best practices, and consequences related to sports participation/restriction. The CCS Sport Group recently published Canada’s first recommendations for the Cardiovascular Screening and Care of the Athlete Program. This Joint Position Statement by the CCS and CHRS is globally unique in its detailed description of the SDM process, including provision of: Choice Awareness, Options Dialogue, and the Decision Discussion. This workshop does the critical task of disseminating this recommended standard of care for the cardiovascular health of Canadian athletes. The Position Statement calls for a systematic approach to screening, emphasizing appropriate screening assessment, investigations, and interpretation, in addition to management, counselling and follow-up. It outlines how institutions should employ a stepwise approach to athletic cardiovascular care, where a foundation of high-quality emergency protocols, access to sports cardiology expertise, and a SDM approach are required, prior to the addition of three screening tiers, including a history questionnaire, physical examination, and electrocardiogram. The SDM approach underpins the program described as it is the basis for non-binary discussion with respect to the impact of cardiovascular abnormalities and devices upon participation, restriction, or return-to-play.
Currently there is a lack of training in the area of sports cardiology provided to both cardiology residents and trainees of other disciplines involved in the cardiovascular care of athletes. Overall, Canadian health professionals, particularly those working with athletes, must be informed and educated on how to effectively screen for cardiac conditions, harnessing the expertise of their collaborative partners to create a multi-disciplinary cardiovascular care team. With sudden cardiac death (SCD) as the leading medical cause of death among competitive athletes, increased knowledge of sports cardiology is essential to ensure the health and safety of athletes across Canada.
The focus of this workshop is to disseminate the SDM as detailed in the CCS/CHRS Joint Position Statement to educate health professionals on the identification and management of at-risk athletes, particularly those with abnormalities relating to SCD, using a non-binary approach. Each presenter will provide cases illustrating the assessment and management of athletes with clinically significant conditions, particularly hypertrophic cardiomyopathy, arrhythmia, and coronary anomalies. The workshop is endorsed by CHRS.