Sudden cardiac death of athletes

Sudden cardiac death (SCD) in athletes is a tragic event that brings to light the potential dangers of underlying, often undiagnosed, cardiovascular conditions. Despite its low prevalence, the impact of SCD is substantial due to the unexpected loss of young, seemingly healthy individuals. Sudden cardiac death in athletes is typically defined as an unexpected death due to cardiac arrest within an hour of the onset of symptoms, excluding the additional time on mechanical life support. Most of these deaths are linked to congenital or acquired cardiovascular disease with no symptoms noted before the fatal event. The single most important predictor is fainting or near-fainting during exercise.

Causes

The primary causes of SCD in athletes are congenital or acquired cardiovascular diseases. These may include conditions such as hypertrophic cardiomyopathy, coronary artery anomalies, and arrhythmogenic right ventricular cardiomyopathy. Other conditions, like Marfan syndrome and long QT syndrome, can also predispose an athlete to SCD.

Screening

Current screening methods for SCD in athletes include physical examinations, family and personal medical history, and an electrocardiogram (ECG). However, these methods are not perfect, as they often lack sensitivity and specificity. As a result, there is an ongoing debate regarding the best practices for screening and the potential use of additional methods, such as echocardiography and genetic testing.

Management and Prevention

The most effective strategy for preventing SCD in athletes is the identification and management of individuals at risk. This includes comprehensive screening and appropriate follow-up of abnormal findings. In some cases, athletes with certain conditions may be advised to refrain from competitive sports.

The presence of automated external defibrillators (AEDs) at sports events and training facilities is also crucial, as immediate defibrillation significantly improves survival rates in the event of a cardiac arrest.

See Also

• Hypertrophic cardiomyopathy
• Long QT syndrome
• Marfan syndrome
• Automated external defibrillator

References

• 1. Harmon, K. G., Asif, I. M., Maleszewski, J. J., Owens, D. S., Prutkin, J. M., Salerno, J. C., Zigman, M. L., Ellenbogen, R., Rao, A. L., Ackerman, M. J., & Drezner, J. A. (2016). Incidence, Cause, and Comparative Frequency of Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A Decade in Review. Circulation, 134(1), 10–19.
• 2. Maron, B. J. (2003). Sudden death in young athletes. New England Journal of Medicine, 349(11), 1064-1075.
• 3. Drezner, J. A., Sharma, S., & Baggish, A. (2017). International criteria for electrocardiographic interpretation in athletes: Consensus statement. British Journal of Sports Medicine, 51(9), 704-731.
• 4. Maron, B. J., & Zipes, D. P. (2005). 36th Bethesda Conference: Eligibility recommendations for competitive athletes with cardiovascular abnormalities. Journal of the American College of Cardiology, 45(8), 1312-1375.
• 5. Drezner, J. A., O'Connor, F. G., Harmon, K. G., Fields, K. B., Asplund, C. A., Asif, I. M., ... & Landry, G. L. (2017). AMSSM position statement on cardiovascular preparticipation screening in athletes: current evidence, knowledge gaps, recommendations and future directions. British Journal of Sports Medicine, 51(3), 153-167.

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