Post-ROSC workup:
Evaluate like nonathletes — interpret like athletes
QTc often prolonged post-arrest → reassess 3–5 days
Echo may miss apical HCM/ARVC → CMR
CCTA = for anomalous coronaries
LGE on CMR: fibrosis ~38% of healthy athletes → avoid overcalling pathology
Emergency Action Plans (EAPs)
Secondary prevention = survival
Treat collapse + unresponsiveness as SCA → AED on immediately
Target: collapse-to-shock <3 minutes
Recent survival reports: ~48% to 89%
EMS activation • CPR • Early defib • AED maintenance • Team rehearsal
Screening: H&P vs ECG
H&P alone: low sensitivity + high false positives
ECG: detects ~2/3 of lethal disorders (with modern athlete-ECG criteria)
Meta-analysis (47,137 athletes):
WPW: 1 / 703
HCM: 1 / 2613
LQTS: 1 / 2613
Practical: ECG improves detection efficiency.
Etiology (modern autopsy series, 11–39y)
What causes SCD in young athletes?
Approx. distribution:
Autopsy-negative SUD: ~19%
HCM: ~13%
Coronary anomalies: ~11%
ACM: ~10%
CAD: ~8%
Myocarditis-related: ~6%
Aortic dissection: ~4%
WPW: ~3%
Note: ≥25y → CAD dominates.
Disparities (sex-race)
Risk is not evenly distributed
Male athletes: 1/35,000–83,000
Female athletes: 1/93,000–323,000
College athletes:
Black: 1/18,000 athlete-years
White: 1/39,000 athlete-years
HS survival after SCA:
51% (underrepresented groups) vs 76% (nonHispanic White)
How often does SCA/SCD occur?
Prepubertal: ~1 / 500,000 athlete-years
Adolescents (13–17): 1 / 66,000–88,000
College athletes: 1 / 51,000–67,000
Bottom line: risk rises with age + ascertainment.
Sudden Cardiac Arrest in Athletes (SCA)
❤️What cardiologists should know (NEJM 2026)
Rare • High-impact • Preventable outcomes
Key takeaways:
Incidence varies • Causes differ by age • EAPs save lives • RTP is evolving
Link: www.nejm.org/doi/pdf/10.1...
@NEJM
@drmarthagulati.bsky.social @vineetaojha.bsky.social @vassv.bsky.social @accintouch.bsky.social @annakatebarton.bsky.social @escardio.bsky.social @cvprevention.medsky.social @worldheart.org @jgrapsa.bsky.social @katehanneman.bsky.social @ijcvimaging.bsky.social
9️⃣ genetics!
💥 some genetic mutation are at higher risk than others and need closer follow-up
8️⃣ cardiovascular imaging reccomandation
#exhofisrt #whyCMR #yesCCT
Here 👇
7️⃣ For women with mechanical heart valves—anticoagulation regimens must be carefully managed, including switching between VKAs, LMWH, and UFH depending on the pregnancy stage and timing of delivery. ⏱"
6️⃣Planning mode of delivery? These guidelines advise against C-section when not medically necessary— vaginal delivery remains first choice, unless specific cardiovascular conditions warrant otherwise. 👶"
5️⃣ Physiological changes during pregnancy are profound—stroke volume and cardiac output increase by 30–50%, and heart rate by 10–20 bpm. These changes can stress an already compromised heart.
4️⃣ Pregnancy in women with CVD must include shared decision-making, considering genetic background, obstetric history, comorbidities, lifestyle, and values—not just clinical risk. 🤰❤️"
3️⃣ Pregnancy with cardiovascular disease now involves a multidisciplinary Pregnancy Heart Team—specialized care before, during, and after pregnancy leads to fewer maternal deaths and better outcomes. 💪
2️⃣ No more blanket “pregnancy forbidden” policies—for high-risk conditions (like PAH or vascular Ehlers-Danlos), the focus shifts to counselling by a multidisciplinary Pregnancy Heart Team, empowering informed choices. 🏥
ESC Guidelines on Cardio-Pregnancy (2025)
Here my highlights 👇
1⃣ personalized risk assessment for all women with cardiovascular disease considering pregnancy. Shared decision-making is at the heart of the approach🤝
Happy International Women’s Day to all the amazing women in this world!
#AccelerateAction #InternationalWomenDay
#BreakingBarriers
#CardioSky
@antjehellwich.bsky.social @annakatebarton.bsky.social @chriskramermd.bsky.social @glaucomflecken.bsky.social @saraersozlu.bsky.social @escardio.bsky.social @jgrapsa.bsky.social @katehanneman.bsky.social @nmerke.bsky.social @womenasone.bsky.social @purviparwani.bsky.social
Presented at #scmr2025 published in #EHJCVI
unexpected finding at #echofirst
1️⃣MMI in cardiac mass is the key
2️⃣Refers to common mass characteristics but..
3️⃣Always consider patient's anamnesis
👇 What is this cardiac mass?
@vassv.bsky.social @vicferrarimdbs.bsky.social @vineetaojha.bsky.social
@drmarthagulati.bsky.social @purviparwani.bsky.social @vineetaojha.bsky.social @saraersozlu.bsky.social @annakatebarton.bsky.social @glaucomflecken.bsky.social
Among the all talks at #scmr25 i was particularly touched by @ElsieRadiology talk:
1️⃣Find Joy+meaning of ur work
2️⃣Find your people
3️⃣Take initiative
4️⃣Establish a personalized work-life balance
5️⃣Be patient to yourself
Growth comes from experience:learn, evolve, and rise!
Honored to co-moderate the Rapid-Fire Session on Arrhythmias II tomorrow at 5:30 PM in Blue Room Pre-Function Kiosk 1 with my wonderful co-moderator @annagiuliapavon.bsky.social
And right after, join us for the Welcome Reception, where the amazing SCMR Band 5T will be performing! @scmr #SCMR2025
@vineetaojha.bsky.social @vassv.bsky.social @purviparwani.bsky.social @saraersozlu.bsky.social
@rishabhkhurana.bsky.social
@doctiger.bsky.social @jasonnjohnson.bsky.social @annagiuliapavon.bsky.social @alex-kallifatidis.bsky.social @amroalsaid.bsky.social @drjenniferco-vu.bsky.social
#SCMR2025
Happy to start the 2nd day on #whyCMR discussion cardiac masses!
🏠Kiosk 1 - blue room
⏰8-9 AM
👉Many tips and tricks for patients diagnosis and management
👉Learn from cases is essential!
🧲See u there!
#SCMR2025
Ready for the biggest #whyCMR meeting!
📢Quick start tomorrow with clinician preconference
🪙Part of level 1 course!
👉 More info on Eventscribe app
👀 Look for the new insights on quant perf and valvular heart disease
@vineetaojha.bsky.social @scmrorg.bsky.social @saraersozlu.bsky.social
@shehabanwer.bsky.social @vineetaojha.bsky.social @escardio.bsky.social @jgrapsa.bsky.social
👉#whyCMR in Mitral regurgitation!
Significant strides in cardiovascular imaging: 'The relationship between symptoms and regurgitant severity in primary mitral regurgitation: a CMR study.' by @seth_uretsky
Explore in #IJCVI!
👇
doi.org/10.1007/s10554…
🎤🎤🎤🎤Just 4 days to go for @scmrorg.bsky.social annual meeting #SCMR2025- there is still chance to register for the largest #whyCMR meeting, you can attend virtually.
For updates, follow the social media ambassadors⬇️ @purviparwani.bsky.social @saraersozlu.bsky.social @annagiuliapavon.bsky.social
