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Sudden cardiac death in sports: could we save Pheidippides?

Asterios Deligiannis1, Evangelia Kouidi1

  • 1Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Acta Cardiologica
|January 8, 2021
PubMed

Insights

Sudden cardiac death (SCD) in young athletes stems from hereditary heart disease, while older adults face atherosclerotic coronary artery disease (CAD). Preventive strategies include screening, genetic testing, and prompt resuscitation.

Area of Science:

  • Cardiology
  • Sports Medicine
  • Genetics

Background:

  • Hereditary heart diseases are the primary cause of sudden cardiac death (SCD) in athletes under 35.
  • Atherosclerotic coronary artery disease (CAD) is the leading cause of cardiac events in older individuals.
  • Identifying and mitigating cardiovascular risks in athletes is crucial for preventing sudden death.

Purpose of the Study:

  • To outline recommended preventive measures for sudden cardiac death in athletes.
  • To discuss the role of cardiovascular screening, genetic testing, and lifestyle modifications.
  • To highlight the importance of rapid response systems including cardiopulmonary resuscitation and defibrillation.

Main Methods:

  • Review of current literature on cardiovascular risks in sports.
  • Analysis of preventive strategies including pre-participation screening and genetic testing.
  • Discussion of the impact of excessive endurance exercise and doping on cardiac health.

Main Results:

  • Pre-participation screening effectiveness, particularly electrocardiograms, requires further cost-effectiveness analysis.
  • Genetic testing is advised for borderline cases and those with a family history of heart disease.
  • Athletes with implantable cardioverter-defibrillators (ICDs) may participate in sports under specific conditions.
  • Excessive endurance exercise can negatively impact cardiac structures and vessels.
  • Immediate cardiopulmonary resuscitation and defibrillation are vital for reversing cardiac arrest.

Conclusions:

  • A multi-faceted approach combining screening, genetic evaluation, risk factor reduction, and emergency preparedness is essential.
  • Equipping sports venues with automatic external defibrillators (AEDs) is strongly recommended.
  • Further research into the cost-effectiveness of screening methods is warranted.

Keywords:
pre-participation screeningAthletecardiac high-risk factorscompetitive sportsresuscitationsudden cardiac death

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