Shared decision-making and the cardiovascular care of athletes: is it time to get back in the game?

Publication date: Available online 17 October 2019Source: Canadian Journal of CardiologyAuthor(s): Nathaniel Moulson, Paul Dorian, Andrew Krahn, Alice Virani, Saul Isserow, James McKinneyAbstractPrevention of sudden cardiac arrest/death and disease progression have traditionally been the primary basis for determining exercise recommendations for those with underlying cardiovascular disease. Potential harms of exercise restriction, including physical inactivity’s impact on obesity, chronic disease and negative psychological and emotional consequences, have been considered ancillary, if considered at all. Accumulating evidence suggests the relative safety of continued sports and exercise participation in the vast majority of those with a variety of cardiac conditions that were previously considered to be criteria for exclusion. Despite ongoing clinical uncertainty however, respect for patient autonomy and the inclusion of patient values and preferences is now required in the decision-making process. The shared decision-making construct, a cornerstone of patient-centered care, should be applied for determining exercise and participation recommendations for those with cardiovascular disease. Safe exercise principles should be employed in all cases, regardless of whether athletes chose to follow recommendations, following a harm-reduction model. This approach is recommended by the 2019 Canadian Cardiovascular Society (CCS) and Canadian Heart Rhythm Society (CHRS) Joint Position ...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research