Sudden Cardiac Death in Athletes: From the Basics to the Practical Work-Up

Area of Science:

• Cardiology
• Sports Medicine
• Preventive Medicine

Background:

• Sudden cardiac death (SCD) in athletes, though rare, is a significant concern due to rising participation in high-performance sports.
• Identifying the causes of SCD in athletes is complex, necessitating effective preparticipation screening strategies.

Purpose of the Study:

• To review the definitions, epidemiology, and etiologies of sudden cardiac death in athletes.
• To discuss the clinical characteristics and diagnostic approaches for sudden cardiac death in athletes.
• To evaluate the optimal ambulatory investigational strategies for preparticipation screening in athletes.

Main Methods:

• Comprehensive literature review of sudden cardiac death in athletes.
• Analysis of current preparticipation screening tools, including clinical evaluation and electrocardiography (ECG).
• Evaluation of advanced diagnostic technologies such as cardiac magnetic resonance (CMR) as second-line investigations.

Main Results:

• A combination of comprehensive clinical evaluation and a 12-lead ECG represents the most cost-effective initial screening strategy.
• Cardiac magnetic resonance (CMR) offers advanced ventricular evaluation and tissue characterization, overcoming limitations of other imaging modalities.
• The article provides a holistic overview from epidemiology to diagnostic workup for SCD in athletes.

Conclusions:

• Effective preparticipation screening for sudden cardiac death in athletes requires a multi-faceted approach.
• Integrating traditional methods with advanced imaging like CMR can improve diagnostic accuracy.
• Continued research into optimal screening protocols is essential to mitigate the risk of sudden cardiac death in athletic populations.