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Hypertrophic Cardiomyopathy in Athletes.

The Physician and sportsmedicine·2016
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Distinguishing hypertrophic cardiomyopathy from athlete's heart physiological remodelling: clinical significance, diagnostic strategies and implications for preparticipation screening.

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Related Experiment Video

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Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology
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Cardiovascular risks to young persons on the athletic field

B J Maron1

  • 1Minneapolis Heart Institute Foundation, Minnesota 55407, USA.

Annals of Internal Medicine
|September 12, 1998
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Sudden cardiac death in young athletes is rare but concerning, often caused by undetected heart conditions like hypertrophic cardiomyopathy. Current screening methods may be inadequate, highlighting the need for improved preparticipation cardiovascular evaluations.

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Area of Science:

  • Cardiology
  • Sports Medicine
  • Public Health

Background:

  • Sudden cardiac death (SCD) in young athletes is a high-profile concern, though statistically uncommon.
  • Congenital cardiovascular diseases, primarily hypertrophic cardiomyopathy and coronary artery anomalies, are frequent underlying causes.
  • Commotio cordis, a fatal cardiac arrest from chest impact, is an additional risk, potentially mitigated by softer projectiles.

Purpose of the Study:

  • To review the causes and risks of sudden cardiac death in young athletes.
  • To evaluate the effectiveness of current preparticipation screening protocols.
  • To emphasize the need for standardized cardiovascular screening in athletes.

Main Methods:

  • Review of existing literature on SCD in athletes.
  • Analysis of common cardiovascular pathologies and risk factors.
  • Assessment of current preparticipation screening guidelines and their limitations.

Main Results:

  • Hypertrophic cardiomyopathy and coronary artery anomalies are leading causes of SCD in athletes.
  • Arrhythmogenic right ventricular dysplasia may be underdiagnosed.
  • Commotio cordis can occur without structural heart disease or chest injury.
  • Current preparticipation screening may be insufficient due to questionnaire content and examiner training.

Conclusions:

  • Standardized, improved preparticipation screening is crucial for identifying at-risk athletes.
  • Distinguishing hypertrophic cardiomyopathy from athlete's heart requires careful assessment.
  • Recommendations from the 26th Bethesda Conference guide management of identified cardiovascular abnormalities.