Sudden Cardiac Death in Young Athletes: Preparticipation Screening for Underlying Cardiovascular Abnormalities and Approaches to Prevention

Abstract

The study of sudden cardiac death (SCD) in athletes has received more interest in the medical and lay press over the past few years. Professional athletes represent ideals of fitness and health, and the sudden death of prominent athletes can come as a shock. Underlying occult cardiovascular disorders are the most common cause of SCD in athletes. Unfortunately, because these disorders rarely present clinically, their initial manifestation is often a fatal event. Due to this, much attention has turned to both primary and secondary prevention. Primary prevention includes preparticipation screening and secondary prevention includes having automatic external defibrillators available at sporting events. This article summarizes the most common causes of athletic-related cardiac arrest and evaluates the screening methods used to screen for these conditions. The general sentiment is that we need to more effectively identify athletes who are at risk for SCD, but how to do so using an efficient screening system and in a cost-effective manner have not been determined.

Cardiovascular Complications of Energy Drinks

“…These include co-ingestions (e.g., drugs), genetic predispositions, and strenuous exercise. Accordingly, specific causality cannot be attributed to ED consumption alone [1,[83][84][85]. However in light of these patterns, individuals susceptible to the effects of EDs avoid consumption until more safety and efficacy data can be established [1].…”

Sudden Cardiac Death in the Soccer Field: A Retrospective Study in Young Soccer Players From 2000 to 2013

“…3 SCD incidence in athletes is estimated to be 0.4 to 13 cases per 100.000 individuals per year based on prospective 4,5 and retrospective 6,7 studies. In general, the risk of SCD in athletes is approximately 2.5 times greater than in non-athletes, 4,8 with men being 10 times more likely than females to have a SCD event. 4 Sports activity is not the cause of death itself, but it acts as a trigger of cardiac arrest in those with underlying cardiovascular pathologies that predispose to life threatening ventricular arrhythmias.…”

“…8,10,11 To the best of our knowledge there are no autopsy studies evaluating causes of SCD only in young soccer players. It is worth mentioning that most, if not all of these conditions have a strong genetic component, therefore identifying one case can help to identify affected family members.…”

“…It is worth mentioning that most, if not all of these conditions have a strong genetic component, therefore identifying one case can help to identify affected family members. 8,10,11 Recently, Schmied et al did a survey of SCD events in soccer players from 2003 to 2013, using questionnaires directed to FIFA members associations. They mainly focused on outcomes, automatic external defibrillation (AED) use in the events and availability of screening strategies in each FIFA member.…”

“…9 These underlying cardiac conditions have an approximate prevalence of 1:100 to 1:500.000 individuals. 8 Taking into account the current estimates of Fédération Internationale de Football Association (FIFA) active soccer players, 1,2 up to hundreds to hundred thousands individuals worldwide, both amateur and professionals soccer players might have an underlying condition that predisposes them for SCD.…”