Heart Breaking Differences: A Narrative Review of Sex and Gender Disparities in Sports-Related Sudden Cardiac Death

Sports-related sudden cardiac death (srSCD) represents a rare yet significant occurrence. This review aims to explore the epidemiology, etiology, and prevention of srSCD, with a particular focus on the influence of sex and gender. It seeks to analyze existing literature to elucidate the impact of biological variables, societal factors, and preventive measures in understanding and addressing srSCD among athletes.

A narrative review approach was utilized to synthesize relevant literature on srSCD, using a validated PubMed Search tool for sex and gender-related factors. The review focused on primary data investigating sex differences that may contribute to srSCD, as well as pertinent review articles.

The review highlights the complexity of defining and studying srSCD, with challenges stemming from varied reporting methods and lack of standardized definitions. Disparities in incidence rates between male and female athletes are evident, with males exhibiting a disproportionately higher risk. Biological factors, including cardiac adaptations to exercise and sex hormone influences, contribute to these sex-specific differences in srSCD rates. While screening programs, particularly utilizing electrocardiograms, show promise in identifying at-risk individuals, debates persist regarding their implementation and efficacy. Furthermore, legislative gaps in mandating the availability of automatic external defibrillators (AEDs) in public settings underscore the need for unified advocacy efforts to improve access to life-saving interventions.

Understanding the multifaceted nature of srSCD, including its biological underpinnings and societal implications, is crucial for developing effective preventive strategies. Sex-specific screening programs tailored to the unique risk profiles of male and female athletes, as well as legislative initiatives promoting AED placement and cardiopulmonary resuscitation training, are essential components of comprehensive srSCD prevention efforts. By addressing disparities and implementing evidence-based interventions, this paper advocates for a holistic approach to mitigate the risk of srSCD and enhance the safety and well-being of athletes across all levels of competition.