Sudden cardiac death athletes: a systematic review

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Abstract

Previous events evidence that sudden cardiac death (SCD) in athletes is still a reality and it keeps challenging cardiologists. Considering the importance of SCD in athletes and the requisite for an update of this matter, we endeavored to describe SCD in athletes. The Medline (via PubMed) and SciELO databases were searched using the subject keywords "sudden death, athletes and mortality". The incidence of SCD is expected at one case for each 200,000 young athletes per year. Overall it is resulted of complex dealings of factors such as arrhythmogenic substrate, regulator and triggers factors. In great part of deaths caused by heart disease in athletes younger than 35 years old investigations evidence cardiac congenital abnormalities. Athletes above 35 years old possibly die due to impairments of coronary heart disease, frequently caused by atherosclerosis. Myocardial ischemia and myocardial infarction are responsible for the most cases of SCD above this age (80%). Pre-participatory athletes' evaluation helps to recognize situations that may put the athlete's life in risk including cardiovascular diseases. In summary, cardiologic examinations of athletes' pre-competition routine is an important way to minimize the risk of SCD.

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Triggering of sudden death from cardiac causes by vigorous exertion.

Christine M. Albert, Murray A. Mittleman, Claudia U. Chae … (2000)

Retrospective and cross-sectional data suggest that vigorous exertion can trigger cardiac arrest or sudden death and that habitual exercise may diminish this risk. However, the role of physical activity in precipitating or preventing sudden death has not been assessed prospectively in a large number of subjects. We used a prospective, nested case-crossover design within the Physicians' Health Study to compare the risk of sudden death during and up to 30 minutes after an episode of vigorous exertion with that during periods of lighter exertion or none. We then evaluated whether habitual vigorous exercise modified the risk of sudden death that was associated with vigorous exertion. In addition, the relation of vigorous exercise to the overall risk of sudden death and nonsudden death from coronary heart disease was assessed. During 12 years of follow-up, 122 sudden deaths were confirmed among the 21,481 male physicians who were initially free of self-reported cardiovascular disease and who provided information on their habitual level of exercise at base line. The relative risk of-sudden death during and up to 30 minutes after vigorous exertion was 16.9 (95 percent confidence interval, 10.5 to 27.0; P<0.001). However, the absolute risk of sudden death during any particular episode of vigorous exertion was extremely low (1 sudden death per 1.51 million episodes of exertion). Habitual vigorous exercise attenuated the relative risk of sudden death that was associated with an episode of vigorous exertion (P value for trend=0.006). The base-line level of exercise was not associated with the overall risk of subsequent sudden death. These prospective data from a study of U.S. male physicians suggest that habitual vigorous exercise diminishes the risk of sudden death during vigorous exertion.

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Cardiovascular preparticipation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee (clinical cardiology) and Congenital Cardiac Defects Committee (cardiovascular disease in the young), American Heart Association.

Barry J Maron, Jennifer Atkins, B. L. Clark … (1996)

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Sudden cardiac death: epidemiology, transient risk, and intervention assessment.

Robert Myerburg (1993)

To integrate information from the various disciplines that contribute to the understanding of the cause and prevention of sudden cardiac death: identification of new approaches from applied clinical epidemiology; identification and control of transient risk factors; and evaluation of the results of interventions. A broad range of research reports and interpretations of data from English-language journal articles and reviews, published primarily between 1970 and 1993. The fields of study included epidemiology, experimental electrophysiology, clinical observations, and interventions. Continuous literature surveys, done in relation to ongoing clinical and experimental research on sudden cardiac death since 1972. Included on the basis of relevance to the topics discussed and with confirmation of data and concepts by more than one investigator when available. Information from several disciplines was integrated by the authors to synthesize new ways to view the problem of sudden cardiac death. Quantitative information was used primarily to derive qualitative statements about new perspectives on sudden cardiac death. Progress in the prevention of sudden death will require development of new approaches, including epidemiologic techniques to address risk characteristics specific to the problem; characterization of triggering events and identification of specific persons at risk for responding adversely to these events; and methods of evaluating outcomes appropriate to the nature of sudden cardiac death.

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Journal ID (nlm-ta): Sports Med Arthrosc Rehabil Ther Technol

Title: Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology: SMARTT

Publisher: BioMed Central

ISSN (Electronic): 1758-2555

Publication date Collection: 2010

Publication date (Electronic): 3 August 2010

Volume: 2

Page: 19

Affiliations

[1 ]Departamento de Clínica Médica, Disciplina de Cardiologia, Núcleo de Saúde no Esporte, Faculdade de Medicina do ABC, Santo André, SP, Brasil

[2 ]Departamento de Morfologia e Fisiologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil

[3 ]Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil

[4 ]Departamento de Fisioterapia, Universidade Estadual Paulista, Campus de Presidente Prudente, Presidente Prudente, SP, Brasil

[5 ]Departamento de Educação Física e Motricidade Humana, Universidade Federal de São Carlos, São Carlos, SP, Brasil

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Publisher ID: 1758-2555-2-19

DOI: 10.1186/1758-2555-2-19

PMC ID: 2923123

PubMed ID: 20682064

SO-VID: df849319-7008-4c4b-91e4-e9b569515257

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Sudden cardiac death athletes: a systematic review

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Most cited references 50

Triggering of sudden death from cardiac causes by vigorous exertion.

Cardiovascular preparticipation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee (clinical cardiology) and Congenital Cardiac Defects Committee (cardiovascular disease in the young), American Heart Association.

Sudden cardiac death: epidemiology, transient risk, and intervention assessment.

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