Adrenal Insufficiency
29 de março de 2021Sinusitis/Rhinosinusitis
29 de março de 2021Checklist for Therapeutic Use Exemption (TUE) Application:
Cardiovascular Conditions
Prohibited Substances: Beta-blockers
This Checklist is to guide the athlete and their physician on the requirements for a TUE application that will allow the TUE Committee to assess whether the relevant ISTUE Criteria are met.
Please note that the completed TUE application form alone is not sufficient; supporting documents MUST be provided. A completed application and checklist DO NOT guarantee the granting of a TUE. Conversely, in some situations a legitimate application may not include every element on the checklist.
| • | TUE Application form must include: | |
| • | All sections completed in legible handwriting | |
| • | All information submitted in [language] | |
| • | A signature from the applying physician | |
| • | The Athlete’s signature | |
| • | Medical report should include details of: | |
| • | Medical history: family history of the disease, symptoms, presentation at first manifestation, course of disease, start of treatment | |
| • | Findings on examination: pulse quality, auscultation, any signs of heart failure | |
| • | Interpretation of symptoms, signs and test results by a specialist physician; i.e. cardiologist | |
| • | Diagnosis (stable angina pectoris; secondary prevention after myocardial infarction; symptomatic heart failure II-IV); supraventricular and ventricular arrhythmias; Long QT syndrome; acute coronary syndrome; hypertension without other risk factors) | |
| • | Medication prescribed (beta-blockers are prohibited in specific sports only) including dosage, frequency, administration route | |
| • | Trial of use of non-prohibited treatment and outcome: important to show that alternatives are either not effective or not available | |
| • | Consequences to the athlete if beta-blocker treatment was withheld | |
| • | Diagnostic test results should include copies of; | |
| • | Laboratory tests: biomarkers as applicable (creatine kinase, troponin I and T, myoglobin, BNP and NT-proBNP) | |
| • | Resting ECG, stress ECG, Holter monitoring blood pressure readings as applicable | |
| • | Imaging findings: chest radiograph, magnetic resonance imaging, repeated measures of ejection fraction and structural remodeling, radionuclide ventriculography and nuclear imaging (myocardial scintigraphy), coronary CT, echocardiography and coronary angiography as applicable | |
| • | Additional information included | |
| • | As per ADO specification (e.g., performance results before and under treatment) | |
