Sudden Cardiac Death in Athletes
2016 Apr-Jun Methodist DeBakey Cardiovascular Journal
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4969030/
“Sudden cardiac death (SCD) is the most frequent medical cause of sudden death in athletes, and estimates vary widely based on the population.”
“Though SCD is rare, its occurrence in athletes who are often young and presumably healthy has a large emotional and social impact on the surrounding community.”
“The definition of an athlete varies. A competitive athlete has been proposed to be “one who participates in an organized team or individual sport that requires competition against others as a central component, places a high premium on excellence and achievement, and requires some form of systematic (and usually intense) training.” This definition is considerably easier to apply to high school, collegiate, and professional organized sport participants but more difficult to apply to younger and older populations who participate in recreational activities (i.e., a heterogeneous group of adults participating in a running race). Therefore, when estimating SCD incidence, the population of athletes “at risk” may be difficult to quantify.”
“The most common causes of SCD in athletes are shown in Table 2. In athletes under 35 years of age, inherited cardiac conditions predominate, with hypertrophic cardiomyopathy (HCM) and anomalous origin of a coronary artery being the two most common causes in the United States. In athletes older than 35, most SCD events are due to acquired atherosclerotic coronary artery disease. Many of these diagnoses may not be clinically apparent and may first present with sudden death.”
“Although rare, SCD in the athlete is a traumatic event that has a large impact on society. The incidence of SCD varies widely depending on the athlete population. In older athletes, SCD is primarily due to CAD and associated complications. In younger athletes, it is due to congenital or genetically mediated cardiovascular disease, such as HCM, coronary artery anomalies, other cardiomyopathies, or primary arrhythmogenic disorders. All preparticipation screening programs aimed at identifying athletes at high risk of SCD begin with a focused history and physical. The addition of the 12-lead ECG and/or additional cardiac testing is a source of considerable ongoing debate. The optimal preparticipation evaluation for a given group depends on the athlete population and the available screening resources, including clinicians with expertise in the cardiovascular care of athletes. It is highly unlikely that any screening program will be effective at appropriately identifying all athletes at risk of SCD; therefore, increased access to automated external defibrillators as well as training in cardiopulmonary resuscitation at a community level are important means of reducing SCD in athletes.”