Publications by authors named "Robert W Battle"

The last few decades have seen substantial growth in the populations of competitive athletes and highly active people (CAHAP). Although vigorous physical exercise is an effective way to reduce the risk of cardiovascular (CV) disease, CAHAP remain susceptible to inherited and acquired CV disease, and may be most at risk for adverse CV outcomes during intense physical activity. Traditionally, multidisciplinary teams comprising athletic trainers, physical therapists, primary care sports medicine physicians, and orthopedic surgeons have provided clinical care for CAHAP.

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Over several decades, much has been learned about the diverse physical impacts of exercise. Those who excel, such as elite athletes, have physiologic differences compared with the general population. There is a growing body of data suggesting that gender may play a role in these adaptations.

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Introduction: Coronary artery anomalies are the second most common congenital cause of sudden cardiac death in young athletes. Some centers have advocated for limited transthoracic echocardiogram (TTE) protocols in the screening of college athletes, which may miss important causes of sudden cardiac death.

Purpose: The purpose of this study was to evaluate the ability of screening TTE to determine the origin and proximal course of the coronary arteries in intercollegiate athletes.

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Since outcomes for patients with congenital heart disease (CHD) have greatly improved, most patients with CHD are surviving into adulthood and creating dilemmas for practitioners with regard to competitive sports participation. Much time, effort, and expertise have gone into developing the new American Heart Association/American College of Cardiology's guidelines and the European Society of Cardiology's guidelines. Practitioners should consult the guidelines but also be aware of gaps in the literature and should individualize recommendations for each patient.

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Background: Both intense endurance training and valvular regurgitation place a volume load on the right and left ventricles, potentially leading to dilation, but their effects in combination are not well-known.

Purpose: The purpose of this case series is to describe the combined volume load of intense endurance athletic training and regurgitant valvular disease as well as the challenging assessment of each component's cardiovascular effect.

Methods: In this article, the clinical course of three elite endurance athletes with congenital valvular disease were reviewed.

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Since antiquity, the athlete has been elevated to a heroic status both within small communities and at the international level. Although numerous population studies have estimated athletic sudden death to be a rare event, the consequences resonate far beyond those directly affected. Sports cardiology has evolved as a result of these tragedies, which highlighted a need for safer play and more programmatic protection of the athlete in play.

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A primary objective of the preparticipation physical examination is to identify athletes at increased risk for sudden cardiac arrest (SCA). Review of an athlete's family history may identify those at risk for SCA. Genetic testing for inherited cardiovascular disease has emerged as a valuable addition to the repertoire of cardiologists facing the decision of clearing athletes with concerning clinical signs and/or family histories.

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This article is a commentary on the role of sports cardiologists in the athletic arena and the beneficial impact they offer sports medicine in the comprehensive care of competitive athletes. The focus is a dialogue on current recommendations for primary prevention of sudden cardiac arrest (SCA), incorporating elements of the preparticipation evaluation and continuing care of athletes with diagnosed heart disease (HD). The feasibility and potential advantages of implementing well-designed preparticipation cardiovascular screening programs and the role of sports cardiologists to educate primary care team physicians on secondary prevention of SCA and proper treatment of underlying HD are discussed.

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In the obscure short story “A Tale of the Ragged Mountains,” Edgar Allen Poe meticulously described a character with features remarkably consistent with the Marfan syndrome. This description appeared in fiction >50 years before the celebrated index description in the published medical research by Professor Antoine Marfan in Paris in 1896.

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This article addresses programmatic cardiovascular screening and evaluation of the elite athlete at the intercollegiate, national team, professional, and Olympic levels. Although much of this content may apply to high-school and recreational sports at large, it is not specifically designed to address athletes participating in all sports activities.

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