Sudden Cardiac Death in Athletes: Consensuses and Controversies

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2023 Jul 5

PMID 37404395

Authors

Usman Ghani

Omer Farooq

Sundus Alam

Muhammad Junaid Khan

Omar Rahim

Sarah Rahim

Affiliations

Soon will be listed here.

Abstract

Exercise is widely considered beneficial for cardiovascular health. However, on rare occasions, athletes experience sudden cardiac death without any preceding symptoms. The devastating nature of these events necessitates us to understand the underlying causes. In younger athletes (age <35), the underlying causes are usually hereditary/genetic, whereas in older athletes (age >35), coronary artery disease is prevalent. Sudden cardiac death in athletes can occur regardless of the presence of any structural abnormality in the heart. Despite divergence between guidelines, the majority of cardiology societies recommend at least taking a comprehensive history and performing physical examinations for initial screening for all athletes. This article reviews the consensuses and controversies regarding the incidence, causes, and prevention of sudden cardiac death in athletes.

Citing Articles

The Changing World of Sports Physical Therapy.

Mangine R Int J Sports Phys Ther. 2024; 19(3):94379.

PMID: 38439780 PMC: 10909393. DOI: 10.26603/001c.94379.

References

Van Camp S, Bloor C, Mueller F, Cantu R, Olson H . Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc. 1995; 27(5):641-7. View

Steinvil A, Chundadze T, Zeltser D, Rogowski O, Halkin A, Galily Y . Mandatory electrocardiographic screening of athletes to reduce their risk for sudden death proven fact or wishful thinking?. J Am Coll Cardiol. 2011; 57(11):1291-6. DOI: 10.1016/j.jacc.2010.10.037. View

Schwartz P, Priori S, Spazzolini C, MOSS A, Vincent G, Napolitano C . Genotype-phenotype correlation in the long-QT syndrome: gene-specific triggers for life-threatening arrhythmias. Circulation. 2001; 103(1):89-95. DOI: 10.1161/01.cir.103.1.89. View

Sanz-de la Garza M, Carro A, Caselli S . How to interpret right ventricular remodeling in athletes. Clin Cardiol. 2020; 43(8):843-851. PMC: 7403694. DOI: 10.1002/clc.23350. View

Sharma S, Drezner J, Baggish A, Papadakis M, Wilson M, Prutkin J . International recommendations for electrocardiographic interpretation in athletes. Eur Heart J. 2017; 39(16):1466-1480. DOI: 10.1093/eurheartj/ehw631. View

Emery M, Kovacs R . Sudden Cardiac Death in Athletes. JACC Heart Fail. 2017; 6(1):30-40. DOI: 10.1016/j.jchf.2017.07.014. View

Maison P, Chanson P . Cardiac effects of growth hormone in adults with growth hormone deficiency: a meta-analysis. Circulation. 2003; 108(21):2648-52. DOI: 10.1161/01.CIR.0000100720.01867.1D. View

Mavrogeni S, Bacopoulou F, Apostolaki D, Chrousos G . Sudden cardiac death in athletes and the value of cardiovascular magnetic resonance. Eur J Clin Invest. 2018; 48(7):e12955. DOI: 10.1111/eci.12955. View

Han J, Lalario A, Merro E, Sinagra G, Sharma S, Papadakis M . Sudden Cardiac Death in Athletes: Facts and Fallacies. J Cardiovasc Dev Dis. 2023; 10(2). PMC: 9965876. DOI: 10.3390/jcdd10020068. View

10.

Harmon K, Asif I, Klossner D, Drezner J . Incidence of sudden cardiac death in National Collegiate Athletic Association athletes. Circulation. 2011; 123(15):1594-600. DOI: 10.1161/CIRCULATIONAHA.110.004622. View

11.

Chandra N, Bastiaenen R, Papadakis M, Sharma S . Sudden cardiac death in young athletes: practical challenges and diagnostic dilemmas. J Am Coll Cardiol. 2013; 61(10):1027-40. DOI: 10.1016/j.jacc.2012.08.1032. View

12.

Henriques de Gouveia R, Corte Real Goncalves F . Sudden cardiac death and valvular pathology. Forensic Sci Res. 2019; 4(3):280-286. PMC: 6713097. DOI: 10.1080/20961790.2019.1595351. View

13.

Wu A, Das S . Sudden death in dilated cardiomyopathy. Clin Cardiol. 1999; 22(4):267-72. PMC: 6656160. DOI: 10.1002/clc.4960220404. View

14.

Suzuki-Yamanaka M, Ayusawa M, Hosokawa Y, Hirose N, Kaneoka K . Epidemiology of sudden cardiac death and sudden cardiac arrest with resultant disability during high school organized sport in Japan. J Sci Med Sport. 2022; 25(9):705-709. DOI: 10.1016/j.jsams.2022.06.011. View

15.

Sealy D, Pekarek L, Russ D, Sealy C, Goforth G . Vital signs and demographics in the preparticipation sports exam: do they help us find the elusive athlete at risk for sudden cardiac death?. Curr Sports Med Rep. 2010; 9(6):338-41. DOI: 10.1249/JSR.0b013e3182014ed6. View

16.

Zhu K, Tang L, Wu S, Tang Y . Out-of-hospital cardiac arrest in a young adult survivor with sequelae of childhood Kawasaki disease: A case report. World J Clin Cases. 2019; 7(21):3583-3589. PMC: 6854418. DOI: 10.12998/wjcc.v7.i21.3583. View

17.

Holst A, Winkel B, Theilade J, Kristensen I, Lange Thomsen J, Ottesen G . Incidence and etiology of sports-related sudden cardiac death in Denmark--implications for preparticipation screening. Heart Rhythm. 2010; 7(10):1365-71. DOI: 10.1016/j.hrthm.2010.05.021. View

18.

Harmon K, Asif I, Maleszewski J, Owens D, Prutkin J, Salerno J . Incidence, Cause, and Comparative Frequency of Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A Decade in Review. Circulation. 2015; 132(1):10-9. PMC: 4496313. DOI: 10.1161/CIRCULATIONAHA.115.015431. View

19.

Maron B, Levine B, Washington R, Baggish A, Kovacs R, Maron M . Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 2: Preparticipation Screening for Cardiovascular Disease in Competitive Athletes: A Scientific Statement From the American Heart.... Circulation. 2015; 132(22):e267-72. DOI: 10.1161/CIR.0000000000000238. View

20.

Vora A, Burkule N, Contractor A, Bhargava K . Prevention of sudden cardiac death in athletes, sportspersons and marathoners in India. Indian Heart J. 2018; 70(1):137-145. PMC: 5903013. DOI: 10.1016/j.ihj.2017.12.004. View