Sudden Cardiac Death in Young Athletes; a Literature Review and Special Considerations in Asia

Halabchi, Farzin; Seif-Barghi, Tohid; Mazaheri, Reza

doi:10.5812/asjsm.34818

Cited by 33 publications

(31 citation statements)

References 104 publications

(191 reference statements)

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“…The American College of Preventive Medicine does not recommend the ECG, exercise treadmill testing, electron-beam CT, ankle-brachial index, carotid intima thickness, or contemporary risk factors including high-sensitivity C-reactive protein in asymptomatic patients [78].The current potential for imperfect decision-making has led to a continuous debate about a suitable preparticipation athletic screening exam. Because of the enormity of the athletic population and the low incidence of sudden death the challenge is analogous to finding a needle in the haystack [20][21][22][23]. In order to definitively address this challenge we must focus on identifying and quantifying imminent risk based on validated causality; not population based associations, or long-term risk prediction.…”

Section: Guidelinesmentioning

confidence: 99%

Part I - Sudden Cardiac Death in Athletes Pathophysiologic Screening: A Transformative Solution to a Social Imperative

Paterick¹

2015

JESO

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Section: Guidelinesmentioning

confidence: 99%

Part I - Sudden Cardiac Death in Athletes Pathophysiologic Screening: A Transformative Solution to a Social Imperative

Paterick¹

2015

JESO

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“…The risk for SCD in young athletes with cardiovascular disease is 2.5 times higher than that in non‐athletes. More than 90% of SCDs occur during or immediately after a training session or competition [35,36]. Astronauts usually get plenty of exercise in the ISS during their missions.…”

Section: Possible Fatal Arrhythmias During Long‐duration Spaceflightsmentioning

confidence: 99%

“…While IHD accounts for 62% of SCD among the general population in the US [44], the distribution differs amongst younger athletic patients without prior heart disease. In the US, hypertrophic cardiomyopathy (HCM) is the single most common cause of SCD in young athletes, accounting for 35%–50% of the cases [35]. In France, the most common cardiovascular causes were HCM (10%), primitive VF (8%), and congenital coronary artery anomalies (6%) (Fig.…”

Section: Future Potential Cardiac Examinations For Long‐duration Spacmentioning

confidence: 99%

Cardiac arrhythmias during long‐duration spaceflights

Anzai

Frey

Nogami

2013

Journal of Arrhythmia

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Few studies have investigated cardiac arrhythmias during spaceflight. Atrial and ventricular premature contractions, short‐duration atrial fibrillation, and non‐sustained ventricular tachycardia were reported by previous spaceflight programs. Some of these arrhythmias occurred following extravehicular activity in space. Arrhythmias during spaceflight are related with hypokalemia, microgravity, changes in the autonomic nervous system, and physical stress. Some astronauts have needed radiofrequency catheter ablation for atrial arrhythmias. Future long‐duration spaceflights beyond the Earth's orbit may expose astronauts to significant levels of radiation that affect the coronary arteries. Genetic tests for arrhythmias might be added to the present cardiac screening examinations in the future.

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“…Using focused echo/Doppler screening the incidence of a cardiovascular finding in athletes has been reported to be roughly one case in every 170 athletes screened with a "false positive" finding in only 8 of 508 athletes [2,10,[13][14][15]. We describe how to provide a highest quality, exceptionally low cost pathophysiologic athletic screening test, which is validated to differentiate the status of a normal state from an abnormal life-threatening pathophysiologic state.…”

mentioning

confidence: 99%

Part 2 - Sudden Cardiac Death in Athletes Focused Cause-and-Effect Screening

Paterick¹,

Choudhary²,

Chandrasekaran³

et al. 2015

JESO

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Echo/Doppler screening should be looked upon as a strategy used in a select population of healthy, asymptomatic individuals to identify pre-emergent disease. Using focused echo/Doppler screening the incidence of a cardiovascular finding in athletes has been reported to be roughly one case in every 170 athletes screened with a "false positive" finding in only 8 of 508 athletes [2,10,[13][14][15]. We describe how to provide a highest quality, exceptionally low cost pathophysiologic athletic screening test, which is validated to differentiate the status of a normal state from an abnormal life-threatening pathophysiologic state.Matching pre-emergent disease (without phenotypic expression) "associated" with sudden death through diastolic parameters is the key to differentiating normal from abnormal pathophysiology [5,9,[16][17][18][19][20][21][22][23][24]. These data are focused on two principal objectives: detect an imminent life-threatening state at a time when the opportunity for prevention is optimal [25,26], and define the magnitude of imminent risk that enlightens physician decision making and management [23,[26][27][28]. Rule-Out vs. Rule-in ScreeningA sensitive screening approach must be distinguished from a specific screening methodology [5,6]. The current trend in athletic screening is searching for an "abnormal" disease feature in a low risk population. This fact alone (searching for a specific rare event) is a major contributor to the controversies and shortfalls surrounding athletic screening [5,6].The most optimal screening test for a large, asymptomatic athletic population prioritizes testing to confirm wellness and rule out disease. An abnormality in screening would be referred for comprehensive evaluation. The rule out principle is important because the penalty for missing a disease has the potential for athletic death. This principle reduces the number of specific diseases to be considered during screening. All cardiomyopathies are grouped as having abnormal diastolic tissue Doppler examination. Conversely, ruling in a disease is more applicable when confirming a high frequency disease. Confirming wellness AbstractSudden death in an athlete is a tragic event. There is a strong social imperative to implement effective means of predicting and preventing sudden death in athletes. However, the design and implementation of a solution seems unobtainable [2]. Part Two discusses how novel attributes of systems biology and digital technology are capable of delivering high quality, low cost athletic screening. The merit of a transformative idea does not necessarily predict its adoption. The greatest barrier to change lies in the acquiescence to familiar practices even in light of new ideas and technology. The current thought in athletic screening is more centered on specific disease associations (rule-in principle), [3][4][5] and much less about the sensitivity of pathophysiologic causality (ruleout principle) [5][6][7][8].A solution will languish until the expert community takes direct action to embrace 21 s...

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Sudden Cardiac Death in Young Athletes; a Literature Review and Special Considerations in Asia

Cited by 33 publications

References 104 publications

Part I - Sudden Cardiac Death in Athletes Pathophysiologic Screening: A Transformative Solution to a Social Imperative

Part I - Sudden Cardiac Death in Athletes Pathophysiologic Screening: A Transformative Solution to a Social Imperative

Cardiac arrhythmias during long‐duration spaceflights

Part 2 - Sudden Cardiac Death in Athletes Focused Cause-and-Effect Screening

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