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Area of Science:

  • Sports Cardiology
  • Cardiovascular Pathology
  • Athletic Health

Background:

  • Sudden death in athletes, though infrequent, is a significant concern.
  • Cardiovascular diseases account for up to 90% of these tragic events, termed sudden cardiac death (SCD).
  • The etiology of SCD in athletes is strongly age-dependent.

Purpose of the Study:

  • To review the primary cardiac causes of sudden cardiac death in athletes.
  • To briefly summarize non-cardiac causes of sudden death in this population.
  • To discuss current pre-participation screening strategies, highlighting the Italian experience.

Main Methods:

  • Literature review focusing on cardiac causes of SCD in athletes.
  • Analysis of age-related differences in SCD etiology.
  • Examination of pre-participation screening protocols.

Main Results:

  • In young athletes (<35 years), congenital heart diseases like hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and coronary artery anomalies are leading causes.
  • In older athletes (>35 years), coronary artery disease is the predominant cause of SCD.
  • Non-cardiac causes and screening strategies were also summarized.

Conclusions:

  • Understanding age-specific causes of SCD is crucial for prevention in athletes.
  • Pre-participation screening plays a vital role in identifying at-risk individuals.
  • The Italian screening model offers valuable insights for global implementation.