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Sudden cardiac death in young competitive athletes due to genetic cardiac abnormalities
Omar E Wever-Pinzon1, Merle Myerson, Mark V Sherrid
1Division of Cardiology, St Luke's - Roosevelt Hospital Center Columbia University, College of Physicians & Surgeons New York City, NY 10019, USA.
Insights
Sudden cardiac death in young athletes is often due to inherited heart conditions. Screening guidelines, including the use of electrocardiograms (ECG), are debated for preventing these tragic events.
Area of Science:
- Cardiology
- Genetics
- Sports Medicine
Background:
- Sudden cardiac death (SCD) in young athletes is a tragic event, typically caused by underlying inherited cardiac disorders.
- Common genetic abnormalities include hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia.
Purpose of the Study:
- To review the causes of SCD in young athletes.
- To discuss current screening guidelines in Europe and the US for athletic participation.
- To highlight the ongoing debate regarding the utility of the 12-lead electrocardiogram (ECG) in screening.
Main Methods:
- Review of existing literature on SCD in young athletes.
- Analysis of European and United States guidelines for pre-participation screening.
- Discussion of the role and controversy surrounding ECG use in screening protocols.
Main Results:
- Inherited cardiac disorders are the primary cause of SCD in young athletes.
- Screening guidelines exist but differ in their recommendations, particularly concerning ECG use.
- European guidelines mandate ECG screening, while US guidelines do not recommend routine ECG use.
Conclusions:
- Preventable SCD in young athletes necessitates effective screening strategies.
- The debate over routine ECG screening highlights differing approaches to identifying at-risk individuals.
- Further consensus is needed on optimal screening protocols to balance prevention and practicality.
Abstract:
Sudden cardiac death (SCD) in young athletes is generally caused by inherited cardiac disorders. While these events are relatively few compared to other cardiac deaths, they are tragic in that death occurs in a young, otherwise healthy person. The genetic abnormalities most associated with SCD are hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. As a result of growing awareness that these deaths can be prevented, guidelines have been issued in both Europe and the United States to help screen and determine qualification for young persons who want to participate in competitive athletics. There remains debate on the how extensive screening should be, in particular over the use of the 12-lead electrocardiogram (ECG), with European guidelines mandating ECG and United States guidelines not recommending routine use of the ECG.
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