Ep. 116 Understanding Cardiac Risks & Management in Sports Medicine with Dr. Nick Larson

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Ep. 116 Understanding Cardiac Risks & Management in Sports Medicine with Dr. Nick Larson

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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. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction05:39 - Emergency Department Arrival Priorities10:13 - AED Access and Arrest Incidence15:33 - Cardiac Risk Patterns by Age and Sport25:12 - Preparticipation Physical Limitations29:14 - Commotio Cordis and Blunt Chest Injury39:37 - Hypertrophic Cardiomyopathy in Athletes45:56 - Exertional Syncope Workup53:00 - Myocarditis and Viral Risks01:03:44 - Ischemic Events in Older Athletes01:09:39 - AED Use and Emergency Action Plans01:17:16 - Rapid Fire Takeaways01:21:15 - Closing Remarks --- 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. --- 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.123.0659082024 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. Larson https://emcrit.org/ --- BackTable Bone & Sports is the go-to podcast for orthopedic surgeons, sports medicine docs, pain specialists, and MSK radiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

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