Ischemic heart disease

The new section on ischemic heart disease (IHD) among the Italian Sports Cardiology Guidelines (COCIS) provides updated recommendations for the evaluation, management and eligibility of athletes with known or suspected IHD. Emphasizing a risk-stratified approach, the guidelines integrate clinical, functional, and imaging assessments to determine the safety of competitive sports participation. Key updates include considerations for athletes with asymptomatic or subclinical disease. This paper discusses COCIS criteria for risk evaluation in three clinical settings: suspected or stable coronary artery disease (CAD), after revascularization, post-myocardial infarction.