Why the study?
Guidance and education for clinicians caring for tactical athletes with cardiovascular disease or risk were needed due to unique occupational demands and risk considerations.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“We hope this document will significantly aid clinicians caring for tactical athletes with conditions that currently are considered disqualifying for military service. In many cases, however, the underlying problem can be corrected or mitigated, allowing the TA to safely continue service without endangering the missions they are executing.”
“While clinicians have long had guidance for evaluating competitive athletes with CVD, tactical athletes present a unique set of challenges that have not been adequately addressed. A cardiovascular event for a firefighter, police officer or military service member can have implications far beyond the individual, including the success of the mission and lives of others.”
This ACC/AHA scientific statement provides comprehensive clinical guidance on the cardiovascular evaluation and management of tactical athletes to balance occupational demands with individual and community safety.
AIM: The American College of Cardiology/American Heart Association Scientific Statement, "Clinical Considerations for the Care of the Tactical Athlete With Cardiovascular Abnormalities," was written to provide guidance and education for clinicians caring for the tactical athlete (ie, firefighters, law enforcement officers, military) with cardiovascular disease or risk for cardiovascular disease, and for the organizations overseeing the care and wellness of these athletes. The considerations are shaped by the interaction between occupational demands and fit for full duty assessments, including risk discussions about how a cardiovascular event in a tactical athlete could impact teammates' well-being, community safety, and overall mission success. METHODS: This scientific statement is organized into 11 sections focused on cardiovascular disease processes and other topics that are relevant when considering the potential risks and benefits of performing tasks specific to the tactical athlete. Task forces, comprised of experts in tactical athlete domains, sports cardiology, and the respective topics covered, were assigned to each section, and specific "Clinical Considerations Tables" for clinicians to reference were prepared. Comprehensive literature reviews and an emphasis on tactical athlete-focused data, as available, were integral in the writing of all clinical considerations presented. The framework mirrors that of the recently published, "Clinical Considerations for Competitive Sports Participation for Athletes With Cardiovascular Abnormalities: A Scientific Statement From the American Heart Association and American College of Cardiology." STRUCTURE: The specific sections in this document include: Section 1: Tactical Tasks Classification; Section 2: The Tactical Athlete Preparticipation Cardiac Evaluation; Section 3: Ethical and Legal Aspects of Tactical Clinical Management; Section 4: Genetic Cardiomyopathies; Section 5: Myocarditis and Other Acquired Cardiac Conditions; Section 6: Congenital Heart Disease; Section 7: Aortopathy, Bicuspid Aortic Valve, and Spontaneous Coronary Artery Dissection; Section 8: Syncope, SCA, Arrhythmias, and Devices; Section 9: Cardiac Channelopathies; Section 10: Older Tactical Athlete; Section 11: Environmental Exposures, PED/S, and Additional Cardiac Conditions and Considerations. Each section provides a summary detailing the rationale for key clinical considerations and the respective Clinical Considerations Table(s).
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Dineen et al. (2026) conducted a review in Cardiovascular disease or risk in tactical athletes. Clinical guidance and considerations was evaluated. This ACC/AHA scientific statement provides comprehensive clinical guidance and considerations for the evaluation and care of tactical athletes with or at risk for cardiovascular abnormalities.
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