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Atypical Presentations of Exertional Collapse
Caroline Newman1, Karl B Fields2
1From the Department of Pediatrics, University of North Carolina Hospital System, Chapel Hill, NC.
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.
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.
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