Highlights
- •Inherited diseases are leading causes of sudden death in young athletes whereas coronary artery disease is the most common cause in senior athletes.
- •Screening including the ECG allows identification of athletes affected by asymptomatic heart diseases at risk of sudden death.
- •The use of modern criteria for ECG interpretation offers the potential to improve the screening accuracy by reducing the number of false positives.
- •Screening with exercise testing is likely to be effective in patients only in senior athletes with significant coronary risk factors
- •Automated external defibrillators on the athletic field provides a “back-up” for unpredictable arrhythmic cardiac arrest.
Abstract
Competitive sports activity is associated with an increased risk of sudden cardiovascular
death (SCD) in adolescents and young adults with clinically silent cardiovascular
disorders. While in middle-aged/senior athletes atherosclerotic coronary artery disease
accounts for the vast majority of SCDs, in young athletes the spectrum of substrates
is wider and includes inherited (cardiomyopathies) and congenital (anomalous origin
of coronary arteries) structural heart diseases. Inherited ion channel diseases have
been implicated in SCDs occurring with an apparently normal heart at autopsy. Screening
including the ECG allows identification of athletes affected by heart muscle diseases
at a pre-symptomatic stage and may lead to reduction of the risk of SCD during sports.
The use of modern criteria for interpretation of the ECG in the athlete offers the
potential to improve the screening accuracy by reducing the number of false positives.
Screening with exercise testing middle aged/senior athletes engaged in leisure sports
activity is likely to be effective in patients with significant coronary risk factors,
while it is not useful in low-risk subgroups. The availability of automated external
defibrillator on the athletic field provides a “back-up” preventive strategy for unpredictable
arrhythmic cardiac arrest, mostly occurring in patients with coronary artery diseases.
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Article info
Publication history
Published online: March 10, 2017
Accepted:
March 8,
2017
Received:
February 27,
2017
Identification
Copyright
© 2017 Published by Elsevier Ireland Ltd.
