Recognizing Cardiac Red Flags to Keep Athletes Safe

The Paris Room hosted the workshop “Red Flags in Athlete Assessment: What Not to Miss,” led by Course Director Fandi Ahmad, MD. The session focused on key considerations in evaluating athletes at risk of cardiac arrhythmias, covering pre-participation screening, ECG interpretation, syncope, exercise prescription, and return-to-play decisions.

The workshop opened by Tiya Setiadi, MD, presenting “Pre-participation Screening for Potential Arrhythmia: What and Who Need Evaluations,” emphasizing the importance of appropriate cardiovascular assessment before athletes engage in intensive physical activity. Haryadi, MD, followed with “ECG Red Flags in Athletes: Practical Approach for ECG Evaluation in Athletes,” introducing a systematic approach to distinguish physiological adaptations from abnormal findings by integrating ECG results with symptoms, family history, and physical examination.

After the coffee break, Fandi Ahmad, MD, addressed “Syncope in Athletes: Managing the Fear and the Facts,” highlighting important differential diagnoses, including seizures, concussion, metabolic disturbances, cardiac conditions, and psychogenic events.

The workshop continued with “Exercise Prescription for Patients with Cardiac Arrhythmias: Guidelines Fit to Work Revisited,” by Haryadi, MD, discussing individualized exercise recommendations that balance cardiovascular benefits and safety, as well as follow-up considerations after three-dimensional ablation.

The final session, “Return-to-Play After Cardiac Arrhythmia Procedures: Evidence and Guidelines,” was delivered by Tiya Setiadi, MD. Drawing on the 2024 Expert Consensus on Arrhythmias and Return to Play, the session emphasized comprehensive medical evaluation and emergency preparedness for sudden cardiac arrest, including the rule of 3 minutes for AED use. It also highlighted the shift from blanket restrictions toward shared decision-making, taking into account individual risk, mental well-being, and appropriate medical device adjustments.