Etiology of Sudden Death in Sports

Abstract

Conditions predisposing to SCD in sports demonstrate a significant age predilection. The strong association of ARVC and left ventricular fibrosis with exercise-induced SCD reinforces the need for early detection and abstinence from intense exercise. However, almost 40% of athletes die at rest, highlighting the need for complementary preventive strategies.

Implantable Cardioverter‐Defibrillator Therapy in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy: Predictors of Appropriate Therapy, Outcomes, and Complications

“…It has been estimated that ARVD/C accounts for 13% to 16% of cases of SCD in children and young adults 1, 7, 8. Because of this markedly increased risk of SCD and sustained ventricular arrhythmias, ICD therapy represents one of the most important therapeutic modalities for patients diagnosed with ARVD/C.…”

Impact of Demographic Features, Lifestyle, and Comorbidities on the Clinical Expression of Hypertrophic Cardiomyopathy

“…Recent data suggest that SCD occurs during sport in less than 20% of patients with a postmortem diagnosis of HCM, and that young age and male sex are the main independent variables associated with exercise‐induced SCD 42. Second, while HCM has been historically reported as the most common cause of SCD in young athletes in the United States, other conditions such as arrhythmogenic right ventricular cardiomyopathy or sudden arrhythmic death syndrome with a normal cardiac autopsy may be more frequent 43, 44, 45. Furthermore, novel entities such as, unexplained or “idiopathic” LVH (ie, LVH without evidence of significant myocardial disarray) has been reported as a relatively common finding in athletes and nonathletes who died suddenly 44, 45.…”

“…Second, while HCM has been historically reported as the most common cause of SCD in young athletes in the United States, other conditions such as arrhythmogenic right ventricular cardiomyopathy or sudden arrhythmic death syndrome with a normal cardiac autopsy may be more frequent 43, 44, 45. Furthermore, novel entities such as, unexplained or “idiopathic” LVH (ie, LVH without evidence of significant myocardial disarray) has been reported as a relatively common finding in athletes and nonathletes who died suddenly 44, 45. The significance of idiopathic LVH is unclear and postulated theories range from part of the spectrum of HCM, to trigger for fatal arrhythmias in individuals with an underlying arrhythmogenic syndrome, because LVH exacerbates electric instability.…”

Sport and sudden death in children

“…[3], в структуре внезапной смерти необъяснимая внезапная смерть составила 31%, доказанная гипертрофическая кар-диомиопатия -3%, возможная гипертрофическая кардиомиопатия -11%. В отчете 2016 г. Британско-го регистра внезапной сердечной смерти в спорте (2016) [22] во всех возрастах необъяснимая внезапная смерть составила 42%, а гипертрофическая кардио-миопатия -6%. При этом отмечено изменение воз-растной динамики причин смерти.…”