09808 - CARDIOLOGIA DELLO SPORT

Learning outcomes

At the end of the course, students will:

· understand the main cardiovascular responses and adaptations to exercise;

· recognise the main cardiovascular risk factors in young, adult, master, and older athletes;

· understand sex- and gender-related differences in cardiovascular risk associated with sport;

· know the main cardiovascular diseases that may affect sports participation;

· understand the general principles of sports eligibility assessment according to the 2023 COCIS protocols;

· recognise symptoms and warning signs requiring exercise interruption and medical evaluation;

· know the main causes of sudden cardiac death in athletes;

· understand the role of cardiopulmonary resuscitation, automated external defibrillators, and emergency action plans in sports settings;

· understand the potential and limitations of wearable devices for cardiovascular monitoring;

· know the main cardiovascular effects of sports supplements, with particular reference to caffeine and energy drinks;

· critically discuss simple cases and scientific articles in sports cardiology.

Course contents

Prerequisites

Basic knowledge of human anatomy, cardiovascular physiology, exercise physiology, and training methodology is recommended.

Cardiovascular risk and sports participation

· Acute cardiovascular responses and adaptations to training.

· The athlete’s heart and general differences between physiological adaptation and pathological conditions.

· Cardiovascular risk in young, adult, master, and older athletes.

· Atherosclerosis, ischaemic heart disease, and the main cardiovascular risk factors.

· Symptoms and warning signs during physical activity, including chest pain, dyspnoea, palpitations, dizziness, and syncope.

· Sex- and gender-related differences in responses to exercise and cardiovascular complications.

Sports eligibility and the 2023 COCIS protocols

· Purpose of sports eligibility certification.

· Differences between recreational, non-competitive, and competitive sports activities.

· General assessment of cardiovascular risk in athletes.

· Principles of eligibility, temporary suspension, reassessment, and return to sport.

· Roles of the sports physician, cardiologist, and STAS professional.

Selected sections of the 2023 COCIS protocols will be analysed. Students will not be required to memorise all specialist medical criteria.

Cardiovascular diseases and sports participation

General principles concerning sports participation in individuals with:

· ischaemic heart disease;

· arrhythmias;

· cardiomyopathies and previous myocarditis;

· congenital heart disease;

· channelopathies, with particular reference to long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia;

· pacemakers, implantable cardioverter-defibrillators, and other cardiac devices.

The aim is to understand cardiovascular risk, possible limitations, and the need for specialist assessment, rather than to make diagnoses or determine sports eligibility.

Sudden cardiac death and lifesaving equipment

· Definition and main causes of sudden cardiac death in athletes.

· Differences between young athletes and adult or older athletes.

· Family history, syncope, and other possible warning signs.

· Recognition of cardiac arrest.

· Chain of survival.

· Cardiopulmonary resuscitation and early defibrillation.

· Automated or semi-automated external defibrillators.

· Organisation of emergency action plans in sports facilities.

The teaching activities do not replace a certified BLS-D course.

Cardiovascular monitoring devices

· Heart-rate monitors, chest straps, smartwatches, and other wearable devices.

· Monitoring of heart rate, rhythm, and recovery.

· Accuracy, artefacts, false positives, and false negatives.

· Difference between exercise monitoring and medical diagnosis.

· Appropriate action when an abnormal alert is detected.

Supplements, caffeine, and energy drinks

· Use of supplements in sport.

· Reading product labels and assessing total intake.

· Pre-workout products and stimulants.

· Possible cardiovascular effects, including tachycardia, palpitations, increased blood pressure, and sleep disturbance.

· Effects of caffeine on performance, perceived exertion, and the cardiovascular system.

· Individual variability in response.

· Differences between energy drinks and sports drinks in terms of composition and intended use.

· Risks associated with excessive intake, combination with other stimulants or alcohol, and consumption during intense exercise, heat exposure, or dehydration.

Cases and journal club

Examples of cases discussed may include:

· syncope or chest pain during sport;

· palpitations and arrhythmias;

· family history of sudden cardiac death;

· return to sport after cardiovascular disease;

· abnormal alerts from wearable devices;

· excessive consumption of caffeine, energy drinks, or pre-workout products.

The journal club will include the reading and group discussion of selected scientific articles

Readings/Bibliography

Examination preparation will be based on:

· lecture slides;

· teaching materials provided by the lecturer;

· selected sections of the 2023 COCIS protocols;

· scientific articles and documents indicated during the course;

· materials used for journal club activities.

All materials will be made available on the Virtuale platform.

Teaching methods

The course will be delivered in a blended format, combining online and in-person teaching.

Teaching methods will include:

· lectures;

· interactive discussion of cases;

· guided analysis of selected sections of the COCIS protocols;

· discussion of monitoring devices, supplements, and energy drinks;

· journal club activities.

Assessment methods

Assessment methods

The final assessment will consist of a 60-minute written examination.

The examination will mainly include multiple-choice questions and may also include a limited number of short open-ended questions.

The assessment will cover:

· cardiovascular risk in athletes;

· general principles of sports eligibility;

· major cardiovascular diseases and channelopathies;

· sudden cardiac death and emergency management;

· cardiovascular monitoring devices;

· supplements, caffeine, and energy drinks;

· application of knowledge to simple practical cases.

Each multiple-choice question will have one correct answer.

The open-ended questions, when included, will assess the student’s ability to:

· explain concepts clearly and accurately;

· use appropriate scientific terminology;

· apply knowledge to situations relevant to sports practice.

When open-ended questions are included, the number of multiple-choice questions may be reduced proportionally.

The final grade will be expressed on a 30-point scale. The examination is passed with a minimum grade of 18/30.

Successful participation in the journal club will result in a 50% reduction in the total number of questions included in the final examination, but will not directly contribute a separate grade.

Books, notes, mobile phones, smartwatches, electronic devices, and other supporting materials are not permitted during the examination. With regard to assessment, the use of generative Artificial Intelligence is prohibited. Any unauthorised use constitutes a breach of academic integrity.

Students with specific learning disabilities or disabilities

Students with specific learning disabilities or temporary or permanent disabilities are advised to contact the relevant University office in good time.

Any proposed accommodations must be submitted to the lecturer for approval at least 15 days before the examination date. Their suitability will be assessed in relation to the learning outcomes of the course.

Teaching tools

The following tools and materials will support teaching and individual learning:

• lecture slides and summary diagrams;
• scientific articles and consensus documents;
• national and international guidelines;
• practical cases;
• self-assessment questions;
• audiovisual materials, where appropriate;
• the Virtuale platform for sharing teaching materials and course communications;
• online teaching platforms for remote activities.

Generative Artificial Intelligence may be used during individual study as a support for summarisation, reformulation, and self-assessment. AI-generated information must be critically verified against the official teaching materials and the scientific sources indicated by the lecturers.

Office hours

See the website of Anna Vittoria Mattioli