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Exertional collapse associated with sickle trait (SCT) is a serious condition in athletes. Early recognition and management are key to preventing severe outcomes like organ failure.

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Area of Science:

  • Sports Medicine
  • Hematology
  • Emergency Medicine

Background:

  • Sickle cell trait (SCT) can lead to exertional collapse (ECAST) through complex mechanisms.
  • ECAST involves acidosis, rhabdomyolysis, and arrhythmias, causing sickling and end-organ damage.

Observation:

  • Three new cases of ECAST in young athletes are presented, alongside 12 historical examples.
  • ECAST is distinct from exertional heat illness, cardiac events, or asthma, characterized by conscious collapse without neurological deficits.
  • Collapse occurs early in exertion with mild temperature elevation, accompanied by muscle pain and weakness, but not cramping.

Findings:

  • ECAST is triggered by exertional stressors in individuals with SCT.
  • Distinguishing ECAST from other collapse causes is crucial for appropriate management.

Implications:

  • Prompt recognition and emergency department treatment can reverse ECAST in some athletes.
  • Preventative strategies for athletes with SCT are essential to avoid sickling-related collapse.