Cardiovascular side effects of commonly prescribed medications and performance enhancing drugs and special considerations for the athlete

Side effects of commonly prescribed cardiac medications such as anti-arrhythmics have specific implications for athletic performance in athletes with cardiovascular disease. Similarly, non-cardiac medications such as stimulants and anti-depressants may have more pronounced side effects in the setting of athletic activity due to the combination of endogenous and exogenous sympathetic stimulation and altered thermoregulation. This chapter is a summary of the available literature on (a) the implications of prescription medications, both cardiac and non-cardiac, on cardiovascular performance and cardiovascular health of athletic persons, and (b) the implications of potentially performance enhancing drugs known to be widely used by elite and recreational athletes on cardiovascular performance and cardiovascular health.