Episode # 3 • 17 Jan 2025
Understanding Cardiac Risks & Management in Sports Medicine
Which athletes actually carry the highest cardiac risk, and is the sideline ready to act? On this episode of BackTable Bone & Sports, Dr. Larry Balle welcomes Dr. Nick Larson, emergency medicine physician, to discuss cardiac risk, screening, and sideline response for athletes of all ages. They discuss which athletes are at highest risk, what preparticipation screening does (and does not) catch, and how a working relationship with cardiology and a strong emergency action plan can change outcomes.
Timestamps
00:00 - Introduction
05:39 - Emergency Department Arrival Priorities
10:13 - AED Access and Arrest Incidence
15:33 - Cardiac Risk Patterns by Age and Sport
25:12 - Preparticipation Physical Limitations
29:14 - Commotio Cordis and Blunt Chest Injury
39:37 - Hypertrophic Cardiomyopathy in Athletes
45:56 - Exertional Syncope Workup
53:00 - Myocarditis and Viral Risks
01:03:44 - Ischemic Events in Older Athletes
01:09:39 - AED Use and Emergency Action Plans
01:17:16 - Rapid Fire Takeaways
01:21:15 - Closing Remarks
Resources
- Petek BJ, Churchill TW, Moulson N, et al. Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A 20-Year Study. Circulation. 2024. https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065908
- 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy. Circulation. 2024. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001250
- Revisiting Commotio Cordis: Novel Insight Into Clinical Variability, Diagnosis, Epidemiology, and Prevention. Journal of the American Heart Association. 2025. https://www.ahajournals.org/doi/10.1161/JAHA.125.045115
- National Athletic Trainers' Association Position Statement: Emergency Action Plan Development and Implementation in Sport. Journal of Athletic Training. 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11220767/
- Life in the Fast Lane (LITFL), recommended on air by Dr. Larson https://litfl.com/
- EMCrit Project, recommended on air by Dr. Larsonhttps://emcrit.org/
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More about this episode
The conversation covers the diagnosis and management of commotio cordis, hypertrophic cardiomyopathy, myocarditis, and ischemic events in both young and older athletes. Dr. Larson shares his approach to exertional syncope, red flags for on-field collapse, the practical realities of AED use, and why follow-up is critical after the initial event. The episode closes with advice on team drills, the importance of rapid decision-making, and why “time is tissue” when cardiac emergencies strike on the field or sideline.
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