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Sudden cardiac death in athletes
1Papworth Hospital, Cambridge, UK.
Insights
Sudden death in athletes is often caused by undiagnosed congenital cardiovascular abnormalities like hypertrophic cardiomyopathy. While screening is not cost-effective, medical professionals must recognize potential causes in athletes.
Area of Science:
- Cardiology
- Sports Medicine
- Pathology
Background:
- Sudden death in athletes, though rare, is a significant concern.
- Undiagnosed congenital cardiovascular abnormalities are the primary cause in young athletes.
- Coronary atherosclerosis is a leading cause in older athletes.
Purpose of the Study:
- To review the causes of sudden death in athletes.
- To highlight the importance of recognizing cardiovascular abnormalities.
- To inform medical professionals about potential risks.
Main Methods:
- Literature review of sudden cardiac death in athletes.
- Analysis of common and rare cardiovascular causes.
- Discussion of diagnostic and screening approaches.
Main Results:
- Congenital heart defects (hypertrophic cardiomyopathy, coronary anomalies) are most common in young athletes.
- Idiopathic left ventricular hypertrophy, arrhythmogenic right ventricular dysplasia, and Marfan's syndrome are also implicated.
- Coronary atherosclerosis is the main cause in older athletes.
Conclusions:
- Medical professionals must be aware of potential causes of sudden death in athletes.
- Symptomatic athletes require thorough investigation.
- Current screening programs are likely not cost-effective.
Abstract:
Sudden death in athletes is a rare but tragic occurrence. Congenital cardiovascular abnormalities, usually asymptomatic and often undiagnosed during life, are the main causes in young athletes. Hypertrophic cardiomyopathy and congenital coronary anomalies are the most commonly occurring disorders. Idiopathic concentric left ventricular hypertrophy (non-physiological), arrhythmogenic right ventricular dysplasia and Marfan's syndrome with aortic rupture have also been implicated. Rarer causes include mitral valve prolapse and myocarditis. Coronary atherosclerosis is the major cause in older, and occasionally in younger athletes. Those involved in the medical care of athletes should be aware of the potential causes of sudden death in these groups. Symptomatic athletes should be fully investigated. Screening programmes are probably not justified on a cost effective basis.