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Clinical Articles, Lead Article

More screening called for to prevent SCD in young athletes

Sudden cardiac death (SCD) in the sports arena is rare but devastating. It calls for preventive strategies, such as large-scale pre-participation cardiovascular screening (PPS) of competitive athletes and increasing availability of automated external defibrillators, according to a report1 published recently in the Journal of the American College of Cardiology.

The significant infrastructure and expertise required by this challenge should be considered achievable aims rather than impossible goals, say the authors. Victims of SCD are often entirely asymptomatic before their initial presentation and demonstrate only subtle abnormalities on investigation, meaning that cardiac evaluation of an athlete should be performed by trained cardiologists and sports physicians familiar with the conditions capable of causing SCD and the impact of demographic factors associated with the individual athlete, they conclude.

Numerous structural, electrical, and acquired cardiovascular abnormalities are capable of causing SCD, many of which can be identified during life and managed by lifestyle modifications, pharmacotherapy, and device therapy. Strategies for the prevention of SCD, including PPS, are endorsed by sports governing bodies, but mandatory PPS remains rare.

Evaluation of athletes poses diagnostic difficulties, particularly differentiating between physiological adaptation to exercise, known as athlete’s heart, and cardiomyopathic processes capable of causing SCD.

References

1. Chandra N, Bastiaenen R, Papadakis M, Sharma S. Sudden cardiac death in young athletes practical challenges and diagnostic dilemmas.

Published on: March 27, 2013

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ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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