scholarly journals Sudden Cardiac Death in Young Athletes

2020 ◽  
Author(s):  
Leonid Makarov
Keyword(s):  
Sudden Death ◽  
Sports Medicine ◽  
Cardiac Death ◽  
Heart Rhythm ◽  
Position Paper ◽  
Cardiac Conduction ◽  
Competitive Sports ◽  
Young Athletes ◽  
The Usa ◽  
Artery Disease

Sudden death (SD) is the most dangerous and irreversible outcome of diseases in clinical as well as in sports medicine. Between 1980 and 2011, the Sudden Death in Young Athletes Registry in the USA, which was developed based on mass media information, recorded 2406 cases of sudden death, which were observed in 29 diverse sports. In the USA 80% of all SD occurred in high school/middle school or collegiate student athletes, and 20% were engaged in organized youth, postgraduate. Statistical data vary greatly in different countries: SCD incidence rate in the USA is 7.47 and 1.33 per 1,000,000 exercising male and female school-age athletes, respectively, whereas in Italy, the rate is 2.6 cases in men and 1.1 in women per 100,000 individuals per year who are involved in active competitive sports. The European Heart Rhythm Association (EHRA) position paper concluded that as an overall estimate, 1–2 out of 100,000 athletes between of age of 12 and 35 years old die suddenly each year. It was shown that the risk of SCD is significantly higher in athletes than in nonathletes with the same heart condition in the general population, by more than five times for ARVC, 2.6 times for coronary artery disease, 1.5 times for myocarditis, and more than 2 times for cardiac conduction system diseases.

scholarly journals Prevention of sudden cardiac death by the implantable cardioverter defibrilator

2011 ◽  
Vol 64 (5-6) ◽  
pp. 291-294 ◽  
Author(s):  
Dragan Kovacevic ◽  
Anastazija Stojisic-Milosavljevic ◽  
Vasilije Topalov ◽  
Bogoljub Mihajlovic ◽  
Dejan Sakac ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Sudden Death ◽  
Cardiac Death ◽  
Social Insurance ◽  
Heart Rhythm ◽  
Insurance Fund ◽  
Social Insurance Fund ◽  
The Usa ◽  
Rhythm Disorder ◽  
The One

Introduction. Sudden cardiac death or, as it is also called, a modern man?s killer occurs a few hours after the beginning of the disease. Sudden death is the one that happens within an hour from the onset of the subjective discomforts regardless of the existence of any previous disease. According to modern statistics, 450.000 people die suddenly in the USA and 150,000 in Germany. Causes of sudden death. The most frequent causes of sudden death are cardiologic or, in other words, a heart rhythm disorder such as ventricular tachycardia, ventricular fibrillation and bradycardiac rhythm disorder. All these reasons can be efficiently prevented by the implantation of the cardioverter defibrillators. Implantable cardioverter defibrillator. In comparison with the already known medications, the defibrillator seems to be the most efficient in prevention of sudden cardiac death. This fact has been confirmed by large multicentre studies. The implantation itself is a routine procedure. It lasts about an hour and it often passes without any complications. The patient leaves the hospital a few days after the procedure. About 150 of these procedures are performed per year at the Institute of Cardiovascular Diseases Vojvodina. The Social Insurance Fund bears medical costs and the patient only pays the participation fee, which is symbolical if compared to the value and use of the device. Owing to this fact, this device is available to every patient thus making the efficient sudden cardiac death prevention possible.

scholarly journals 407 Is Pickelhaube Sign really the hallmark of arrhythmogenic MVP in athletes? And does MVP really cause sudden death? A case report

2020 ◽  
Vol 22 (Supplement_N) ◽  
pp. N131-N131
Author(s):  
Massimo Bolognesi
Keyword(s):  
Mitral Valve ◽  
Sudden Death ◽  
Mitral Valve Prolapse ◽  
Sports Medicine ◽  
Cardiac Death ◽  
Stress Test ◽  
Mitral Annulus ◽  
Unexpected Death ◽  
Premature Ventricular Contractions ◽  
Military Helmet

Abstract The Pickelhaube Sign is today recognized as a novel Echocardiographic Risk Marker for Malignant Mitral Valve Prolapse Syndrome. Mitral Valve Prolapse (MVP) has long been recognized to be a relatively common valve abnormality in the general population. Patients with relatively non-specific symptoms and asymptomatic athletes who have MVP still represent an important clinical conundrum for any physician involved in preventive medicine and sports screening. Although cardiac arrhythmias and/or cardiac death are an undesirable problem in MVP patients, when these subjects were studied with Holter Electrocardiogram (ECG) monitoring a prevalence of ventricular arrhythmias up to 34% was observed, with premature ventricular contractions as the most common pattern (66% of cases). At this regard a paper by Anders et al. described a series of cases that suggest that even clinically considered benign cases of MVP in young adults may cause sudden and unexpected death. However, cardiac arrest and Sudden Arrhythmic Cardiac Death (SCD) resulted in rare events only in patients with MVP based on data from a community study. A middle-aged athletic male who has been practicing competitive cycling for about 20 years came to our Sports Medicine Centre to undergo screening of sports preparation for competitive cycling and the related renewal of certification for participation in sports competitions. This athlete was always considered suitable in previous competitive fitness assessments performed in other sports medicine centers. His family history was unremarkable, as well as his recent and remote pathological anamnesis. The physical examination revealed a 3/6 regurgitation heart murmur with a click in the mid late systole. Previous echocardiographic examinations revealed a MVP which was considered benign with mild not relevant mitral regurgitation. He did not complain of symptoms such as dyspnoea or heart palpitations during physical activity. The resting ECG showed negative T waves in the inferior limb leads, and the stress test showed sporadic premature ventricular beats (a couple) with right bundle branch block morphology. An echocardiogram confirmed the presence of a classic mitral valve prolapse with billowing of both mitral leaflets, associated with a mild to moderate valve regurgitation. The TDI exam at the level of the lateral mitral annulus showed a high-velocity mid-systolic spike like a Pickelhaube sign, i.e. spiked German military helmet morphology. Consequently, an in-depth diagnostic imaging with cardiac magnetic resonance imaging was proposed, but the athlete refused it, both because he was totally asymptomatic and above all because he would be forced to pay a considerable amount of money as the examination is not guaranteed by the Italian National Health Service. In conclusion, the athlete remained sub judice as for competitive suitability, Finally, the question is: does MVP really cause sudden death? Is it enough to detect the Pickelhaube signal by echocardiography to stop this athlete? Let us bear in mind that this athlete was asymptomatic, and he had not had any trouble during exercise and maximal effort for many years. Why must we declare him unsuitable to do competitive sports?

Sudden Cardiac Death in Young Athletes: A Review for Nurses

1992 ◽  
Vol 3 (1) ◽  
pp. 243-254 ◽  
Author(s):  
Patricia L. Vaska
Keyword(s):  
Health Care ◽  
Coronary Artery ◽  
Hypertrophic Cardiomyopathy ◽  
Sudden Death ◽  
Cardiac Death ◽  
Anomalous Coronary Artery ◽  
Young Athletes ◽  
Health Care Practitioners ◽  
Common Causes ◽  
Anomalous Coronary

Sudden death in young athletes is a rare and devastating event. The most frequent causes of sudden death in this group are hypertrophic cardiomyopathy, anomalous coronary artery, and Marfan syndrome. This article describes the physiology of exercise and the pathophysiology associated with the most frequent causes as well as some of the less common causes of sudden death in young athletes. Identification of youth who may be at risk should be a priority for health care practitioners, and suggestions for recognizing and counseling affected athletes are therefore included

scholarly journals Sudden cardiac death in athletes

2009 ◽  
Vol 62 (1-2) ◽  
pp. 37-41
Author(s):  
Zdravko Mijailovic ◽  
Zoran Stajic ◽  
Dragan Tavciovski ◽  
Radomir Matunovic
Keyword(s):  
Sudden Cardiac Death ◽  
Sudden Death ◽  
Cardiac Death ◽  
Ventricular Hypertrophy ◽  
Ventricular Tachyarrhythmia ◽  
Left Ventricular ◽  
Young Athletes ◽  
Physical Effort ◽  
Social Community ◽  
Esc Guidelines

The entity of sudden cardiac death in young athletes has been known since the year 490 B.C. when young Greek soldier Phidipides had run the distance from Marathon to Athens and suddenly fell down dead. In the last twenty years, sudden death of famous athletes have attracted huge attention of medical and social community; afterwards both American and European Cardiology Societies started to publish periodically guidelines for preparticipation screening. These guidelines have focused on both identifying athletes with potential cardiovascular risk for sudden death and eligibility conditions for athletes participating in competitive sports. Structural and functional abnormalities causing sudden cardiac death in young athletes have been identified by autopsy-based studies. Unrecognized congenital cardiovascular abnormalities associated with excessive physical effort create background for electrophysiological instability and occurrence of malignant ventricular tachyarrhythmia and consequent death. The most frequent causes of sudden cardiac death in young athletes include hypertrophic cardiomyopathy, anomalies of the coronary arteries and idiopathic left ventricular hypertrophy. Current ACC/AHA & ESC guidelines should be widely used in order to reduce potential sudden cardiac death in young athletes.

scholarly journals Cardiac conduction system- A detailed study in 46 cases of sudden death

2015 ◽  
Vol 5 (9) ◽  
pp. 709-716
Author(s):  
LM Ilias ◽  
MR Pai ◽  
S Shukla ◽  
A Ponniah ◽  
K Gautam ◽  
...  
Keyword(s):  
Sudden Death ◽  
Detailed Examination ◽  
Conduction System ◽  
Cardiac Conduction ◽  
Cardiac Conduction System ◽  
Medical College ◽  
System A ◽  
Coronary Lesions ◽  
Artery Disease ◽  
Death Cases

Background: Atherosclerotic coronary artery disease is the modern pandemic and is said to be responsible for a major chunk of sudden cardiac deaths. However, in few cases; especially among the young, conduction system abnormalities were found to be the cause of death with absence of significant coronary lesions. These days, examination of the cardiac conduction system during autopsy has been abandoned as it is said to be a time consuming process. The present study was undertaken to highlight the importance of examining the cardiac conduction system in all sudden death cases.Materials and Methods: This study was a prospective one, conducted from June 2007 to June 2009 in the department of Pathology, Kasturba Medical College, Mangalore. Forty six hearts of persons who died suddenly were studied.Results: Our study showed that even though atherosclerotic coronary lesions were the most common cause of sudden death, cardiac conduction defects also contributed to a significant number of cases; especially in the young. In our study of 46 cases; 6 cases showed only conduction system abnormalities. These were young adults who had died suddenly. The predominant lesion identified in them was fibromuscular dysplasia of the nodal arteries.Conclusion: A detailed examination of the coronaries and the cardiac conduction system should be made mandatory in all sudden death cases, especially in the young as they will help to throw some light into the cause of death.Journal of Pathology of Nepal (2015) Vol. 5, 709-716

Analyzing and Managing Abnormal Heart Rhythms

2015 ◽  
Author(s):  
W. Bruce Fye
Keyword(s):  
Sudden Death ◽  
Cardiac Arrhythmias ◽  
Cardiac Death ◽  
Cardiac Electrophysiology ◽  
Heart Rhythm ◽  
Safety Net ◽  
Diagnostic Techniques ◽  
Appropriate Use ◽  
Heart Rhythm Disorders ◽  
Life Threatening

Cardiac arrhythmias (abnormal heart rhythms) can be life-threatening or simply annoying. Implantable pacemakers were introduced around 1960 to treat slow heart rates that might cause a patient to faint. Sudden cardiac death is usually due to ventricular fibrillation, a very fast chaotic heart rhythm that immobilizes the heart. External defibrillators were used in CCUs, but most patients who experience sudden death are not in hospitals. The introduction of automatic implantable cardiac defibrillators (ICDs) in the mid-1980s provided a safety net for patients at high risk for sudden death. These heart rhythm technologies were expensive, and concerns were raised about their costs and appropriate use. During the final quarter of the century, catheter-based diagnostic techniques were developed to evaluate patients with known or suspected arrhythmias. Cardiologists who focused on heart rhythm disorders were known as electrophysiologists. The emergence of clinical cardiac electrophysiology is an example of continuing subspecialization within cardiology.

scholarly journals Value of electrocardiographic screening for the early diagnosis of arrhythmic and malignant heart disease in pediatric age

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
L Leoni ◽  
A Elhyka ◽  
S Ferretto ◽  
J Fumanelli ◽  
A Cerutti ◽  
...  
Keyword(s):  
At Risk ◽  
Heart Disease ◽  
Sudden Cardiac Death ◽  
Sudden Death ◽  
Cardiac Death ◽  
Heart Diseases ◽  
Sport Activity ◽  
Cardiac Conduction ◽  
Pediatric Age ◽  
Life Threatening

Abstract Funding Acknowledgements Type of funding sources: None. Background The 12-lead electrocardiogram (ECG) is an instrument that can identify cardiac conduction system abnormalities that predispose to sudden cardiac death (SCD) in completely asymptomatic subjects. The rate of sudden cardiac death in pediatric age is estimated to be around 1-1.5 cases per 100.000 individuals, and 10-15% of events occur during physical activity. We evaluated the importance of the electrocardiogram performed in pediatric age in the early detection of asymptomatic electrocardiographic alterations, suggestive for the presence of electrical or structural heart disease potentially at risk for sudden death. Materials and Methods We analyzed 623 patients between 0 and 16 years of age who were sent to the second level pediatric arrhythmology clinic in Padua Hospital between October 2013 and March 2020. The patients were redirected at our clinic after a first finding of electrocardiographic alterations, following ECG performed before the beginning of sport activity, suspected of life-threatening pathologies. The following parameters were evaluated of all patients: clinical suspect of sending the pediatric arrhythmology clinic and electrocardiogram. Then, depending on the type of pathology suspected, the following diagnostic tests were carried out to confirm the clinical suspicion, and if confirmed, to carry out an adequate risk stratification: Holter ECG, ergometric Results Among the evaluated population (623 patients), 393 patients (63%) were sent to the pediatric arrhythmology clinic by sports medicine, 179 (29%) were sent by clinical o family pediatrician, and 51 patients (8%) were sent after ECG performed at hospital facilities for familiarity. The majority, 280 patients (45%), were sent for suspected WPW; 124 patients (20%) were sent for BEV and suspected ARVD; 85 patients (14%) for suspected long QT, 31 patients (5%) for suspected Brugada Pattern; 7 patients (1%) suspected CPVT; 8 patients (1%) for electrocardiographic changes with suspected HCM; 1 patient (0.01%) suspected shortened QT, and 88 patients (14%) for other arrhythmic disorders not at risk of sudden death. The diagnosis of WPW was confirmed in 280 patients, LQTS in 45 patients, SQTS in 1 patient, S. di Brugada in 8 patients, CPVT in 5 patients, HCM in 8 patients and ARVD in 6 patients. Conclusions Our study shows that the electrocardiographic screening already in pediatric age allows the diagnosis and subsequent early treatment of life-threatening arrhythmic heart diseases.

scholarly journals Sudden cardiac death in young athletes

2011 ◽  
Vol 139 (5-6) ◽  
pp. 394-401 ◽  
Author(s):  
Sanja Mazic ◽  
Vladimir Ilic ◽  
Marina Djelic ◽  
Aleksandra Arandjelovic
Keyword(s):  
Coronary Artery ◽  
Sudden Cardiac Death ◽  
Cause Of Death ◽  
Cardiac Death ◽  
Strongly Correlated ◽  
Young Athletes ◽  
Older Athletes ◽  
Artery Disease ◽  
Cardiovascular Evaluation ◽  
Congenital Coronary Artery Anomalies

Cardiovascular diseases are the cause of death in up to 90% of athletes. The most frequent cause of death in young athletes is a sudden cardiac death (SCD). Causes of SCD among athletes are strongly correlated with age. In young athletes (<35 years), the leading causes are congenital cardiac diseases, particularly hypertrophic cardiomyopathy and congenital coronary artery anomalies. By contrast, most of deaths in older athletes (<35 years) are due to coronary artery disease. Although there is no possibility to decrease the risk of SCD to ?zero?, especially in sport competitions, clear recommendations, if available, for cardiovascular evaluation before athletic participation and side effects of sports activities, would minimize the frequency of SCD. If a specific condition of the cardiovascular system is diagnosed, it is necessary to establish the risk of SCD associated with a continual involvement in physical activities and competitive sports, and to define clearly disqualification criteria for each individual athlete.

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