sudden death in competitive sports
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Etiology
- unrecognized hypertrophic cardiomyopathy
- congenital coronary artery anomalies
- subclinical viral myocarditis
- Marfan's syndrome
- right ventricular dysplasia
- blunt chest trauma
- premature coronary artery disease (rare)
- non cardiac causes (14%)[3]
- idiopathic (35%)[3]
- vigorous exercise heightens risk of cardiac arrest[2]
- activation of the sympathetic nervous system
- promotion of plaque rupture
Epidemiology
- 7/1,000,000 for men
- 1/1,000,000 for women
- twice as high in college men as in high school men
- 0.76 per 100,000 athlete-years[8], 50% mortality
- 20% of cardiac arrest in persons age 12-45 years occur during competitive sports[8]
- 2 deaths over 6 years during competitive sports attributed to hypertrophic cardiomyopathy[8]
- none due to arrhythmogenic right ventricular cardiomyopathy
- 20% of cardiac arrest in persons age 12-45 years occur during competitive sports[8]
Management
- screening may save lives[4], or may not[5]
- athletes with pacemakers & ICD may be considered for high- intensity sports; risk for sudden death may be low[6]
- athletes with long-QT syndrome may be considered for competitive sports; risk for sudden death may be low[6]
More general terms
Additional terms
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 18. American College of Physicians, Philadelphia 1998, 2018.
- ↑ 2.0 2.1 Journal Watch 20(24):192, 2000
Albert CM, Mittleman MA, Chae CU et al Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med. 2000 Nov 9;343(19):1355-61. PMID: https://www.ncbi.nlm.nih.gov/pubmed/11070099 Free Article - ↑ 3.0 3.1 3.2 3.3 Journal Watch 25(3):23, 2005
Eckart RE, Scoville SL, Campbell CL, Shry EA, Stajduhar KC, Potter RN, Pearse LA, Virmani R. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med. 2004 Dec 7;141(11):829-34. Summary for patients in: Ann Intern Med. 2004 Dec 7;141(11):I26. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15583223 - ↑ 4.0 4.1 Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 2006, 296:1593 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/17018804 <Internet> http://jama.ama-assn.org/cgi/content/full/296/13/1593
Thompson PD & Levine BD Protecting athletes from sudden cardiac death JAMA 2006, 296:1648 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/17018808 <Internet> http://jama.ama-assn.org/cgi/content/full/296/13/1593 - ↑ 5.0 5.1 Steinvil A et al. Mandatory electrocardiographic screening of athletes to reduce their risk for sudden death: Proven fact or wishful thinking? J Am Coll Cardiol 2011 Mar 15; 57:1291. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21392644
- ↑ 6.0 6.1 6.2 Maron BJ, Zipes DP, Kovacs RJ. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Preamble, Principles, and General Considerations: A Scientific Statement From the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2015 Oct 27. pii: S0735-1097(15)06548-1 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26542655
Maron BJ, Zipes DP, Kovacs RJ. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Preamble, Principles, and General Considerations. A Scientific Statement From the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2015 Oct 27. pii: S0735-1097(15)06548-1 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26542655 <Internet> http://circ.ahajournals.org/content/early/2015/11/02/CIR.0000000000000236 - ↑ Maron BJ. Sudden death in young athletes. N Engl J Med. 2003 Sep 11;349(11):1064-75. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12968091
- ↑ 8.0 8.1 8.2 8.3 8.4 Landry CH, Allan KS, Connelly KA et al Sudden Cardiac Arrest during Participation in Competitive Sports. N Engl J Med 2017; 377:1943-1953. November 16, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29141175 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1615710
- ↑ Maron BJ, Levine BD, Washington RL et al Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 2: Preparticipation Screening for Cardiovascular Disease in Competitive Athletes: A Scientific Statement From the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2015 Dec 1;66(21):2356-2361.Epub 2015 Nov 2. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26542659 Free Article
Maron BJ, Udelson JE, Bonow RO et al Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 3: Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy and Other Cardiomyopathies, and Myocarditis: A Scientific Statement From the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2015 Dec 1;66(21):2362-2371. Epub 2015 Nov 2. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26542657 Free Article
Ackerman MJ, Zipes DP, Kovacs RJ, Maron BJ. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 10: The Cardiac Channelopathies: A Scientific Statement From the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2015 Dec 1;66(21):2424-2428. Epub 2015 Nov 2. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26542662 Free Article
Link MS, Estes NAM 3rd, Maron BJ. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 13: Commotio Cordis: A Scientific Statement From the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2015 Dec 1;66(21):2439-2443. Epub 2015 Nov 2. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26542669 Free Article