Hypertrophic cardiomyopathy as a cause of sudden death

Area of Science:

• Cardiology
• Sports Medicine
• Preventive Cardiology

Background:

• Hypertrophic cardiomyopathy (HCM) is a primary cause of sudden unexpected death in young individuals, particularly athletes.
• The incidence of sudden cardiac death (SCD) in athletes due to HCM is estimated up to 2.3 per 100,000 athletes annually.
• Risk stratification models incorporating patient history and noninvasive test findings aid in assessing individual patient risk.

Purpose of the Study:

• To highlight the role of preparticipation screening in identifying athletes with hypertrophic cardiomyopathy.
• To emphasize the importance of echocardiography in differentiating HCM from athlete's heart.
• To advocate for widespread screening to reduce sudden cardiac death in sports.

Main Methods:

• Review of existing risk stratification models for HCM in athletes.
• Analysis of echocardiographic parameters for distinguishing HCM from athlete's heart.
• Evaluation of the impact of definitive HCM diagnosis and disqualification from sports on SCD reduction.

Main Results:

• Risk stratification models utilize patient history (syncope, family history of SCD) and noninvasive findings (VT, abnormal BP response, LV wall thickness ≥30 mm).
• Echocardiography is crucial for differentiating HCM from the physiological changes of athlete's heart.
• Diagnosis of HCM leads to disqualification from competitive sports, significantly reducing HCM-related SCD during competition.

Conclusions:

• Widespread preparticipation screening of athletes, including historical, clinical, and electrocardiographic evaluation, is recommended.
• Echocardiography should be considered for borderline findings and symptomatic athletes to minimize the risk of sudden cardiac death.
• Early identification and management of HCM in athletes can prevent fatal cardiac events.