Sudden cardiac death in athletes

Abstract

Physical activity is an invaluable tool to fight cardiovascular disease, but physical activity may trigger sudden death (SD) in athletes, especially if they are unknown with an underlying condition. Although the incidence of SD remains rather low in athletes (estimated at 0.5–2 events per 100,000 participants), some data suggest that the overall SD risk is higher in athletes than in sedentary individuals. Most athletes who die suddenly present with a silent cardiac condition, most commonly hypertrophic cardiomyopathy in American series or arrhythmogenic right ventricular cardiomyopathy in European data sets. Other causes of SD include coronary congenital abnormalities, valve disease, channelopathies, or commotio cordis. Based on these data, efforts have been undertaken to reduce the impact of SD in athletes. First, preparticipation screening programmes, including a clinical history, physical examination, and an electrocardiogram (ECG), interpreted through standardized criteria, aim at an early detection of cardiac conditions predisposing to SD. Second, a quick response to a cardiac arrest may save lives; training sports personnel in cardiac resuscitation, readily available automated external defibrillators, and sport medical action plans may critically influence outcomes.