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"In the course of his or her life, a runner is less likely than a non-runner to die of hear t disease," Dr. Jafar says. "However, if the runner is going to die from hea r t disease, he or she is much more li kely to die while running." As non-exercisers of any age begin to work out, they may need to lose weight to do so safely. Sports cardiologists at The Heart Center can make weight-loss recommendations and referrals, and they work with patients to adjust their exercise load to foster weight loss and to help them make optimal use of their enhanced physical abilities. "We have a dedicated space for metabolic testing," Dr. Haleem says. "We help individuals lose weight by teaching them how their heart rate and blood pressure change with exercise, and using that knowledge to achieve weight-loss goals." Athletes also benefit from close collaboration between Health Quest's sports cardiologists and other members of the cardiol- ogy team. "There is significant overlap between sports cardiology and heart failure cardiology, especially with regard to athletes who come to our program because they passed out while training," Dr. Lyons says. "We may help treat a condition that is picked up after the fact." Heart Center specialists can help the patient decide whether it is safe to return to training and how he or she can get back to the desired level of performance. For the young exerciser, inherited or congenital conditions, rather than acquired ones, pose the greatest danger. "The most common cause for sudden death in any professional, collegiate or high school athlete is an underlying cardiomyopathy," Dr. Lyons says. "That may be HCM or another hereditary or family cardiomyopathy that goes undiagnosed during the teen years." Often, the condition reveals itself when the athlete faints during exercise. Other times, it is found during screening. When there is a suspicion of HCM or another inherited condition in a young athlete, the intake procedure includes a physical, family history and EKG. If the EKG is abnormal, providers follow up with an echocardiogram to identify any thickening of the heart, Dr. Lyons says. Abnormal test results may indicate the need for genetic screening, cardiac MRI and additional testing. " People w ith HCM may go undia g nosed for a period of time," Dr. Ha leem says. "In athletes with a certain exercise profile, the heart walls can thicken as well. Therefore, we must identify whether we are looking at HCM or exercise-related remodeling of the athlete's heart." "Once we discover an abnormality, we know the patient has risk factors that put him or her in danger of sudden cardiac death during some forms of exercise. We can then provide a personalized risk assessment." A PARTNER FOR ACTIVE PATIENTS To maximize the level of care in the sports cardiology pro- gram, Health Quest has sought out specialists from an array Jay Freidman, MD*, and Dr. Jafar discuss the VO2 max test results of an athlete. *The physician identified is neither an agent nor an employee of Health Quest or any of its affiliate organizations. The physician has selected our facilities as the place where he wants to treat and care for his private patients. Dr. Jafar (left) and co-workers training for an upcoming event " We have established a 'pit crew' for the most important engine out there — the athlete's heart." — KAMRAN HALEEM, MD, MEDICAL DIRECTOR OF THE CARDIO- ONCOLOGY PROGRAM, THE NON-INVASIVE VASCULAR PROGRAM AND THE ECHOCARDIOGRAPHY PROGRAM AT HEALTH QUEST 0 9 M D N E W S .C O M /// M D N E W S M I D H U D S O N ■ 2 017