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Related Experiment Videos

Sudden death screening

B S Rich1

  • 1Arizona State University, Tempe.

The Medical Clinics of North America
|March 1, 1994
PubMed
Summary
This summary is machine-generated.

Sudden cardiac death (SCD) in athletes is rare but serious. A thorough medical history and physical exam are the most effective ways to identify athletes at risk for SCD, rather than expensive screening tests.

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Area of Science:

  • Cardiology
  • Sports Medicine
  • Preventive Cardiology

Background:

  • Sudden cardiac death (SCD) is a rare but critical event in exercising individuals.
  • Differentiating normal physiological changes from conditions risking SCD in athletes is crucial for practitioners.
  • Causes of SCD vary between athletes under and over 30 years old, with some overlap.

Purpose of the Study:

  • To evaluate the effectiveness of various screening methods for identifying athletes at risk of SCD.
  • To emphasize the importance of clinical history and physical examination in cost-effective risk assessment.
  • To provide guidelines for practitioners in recognizing and managing athletes at risk for SCD.

Main Methods:

  • Review of screening tests including history, physical examination, ECG, echocardiography, and exercise stress tests.

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  • Analysis of the diagnostic yield of different tests for conditions like aortic stenosis, hypertrophic cardiomyopathy (HCM), Marfan syndrome, and coronary artery disease.
  • Inclusion of specific history and physical examination guidelines for pre-competition screening.

    • Main Results:

    • Comprehensive screening tests have not proven cost-effective or consistently reliable in identifying at-risk athletes.
    • A quality history and thorough cardiac screening examination are the most cost-effective methods for identifying athletes at risk for SCD.
    • Combining history, physical exam, ECG, and echocardiography can diagnose most HCM patients at risk; exercise stress tests identify some coronary artery disease and congenital anomalies.

    Conclusions:

    • Clinical history and physical examination are paramount for cost-effective screening of athletes for SCD risk.
    • While some asymptomatic cases present with SCD, a targeted approach can identify most at-risk individuals.
    • Establishing emergency action plans and promoting CPR training are essential for managing cardiac events in athletes.