Athletes and Cardiac Death

About the Auther

syncope temporary loss of consciousness caused by lack of blood supply to the brain; fainting describes a simple syncopal attack.
ventricular cavity the chamber of the ventricle.
ventricular fibrillation the heart muscle does not contract but quivers; therefore, there is no heartbeat (cardiac arrest) and death occurs within minutes if the abnormal heart rhythm is not corrected.
ATHLETES AND SUDDEN CARDIAC DEATH CREATES a dilemma for most clinicians involved in sports medi¬cine. Athletes may have unsuspected serious heart disease and still be relatively asymptomatic. Although rare, these diseases may result in sudden death in young athletes with the catastrophic event emotionally impacting family members, friends, and classmates. In young athletes (median age 17 years), the frequency of cardiac sudden death occurs in approximately 1:70,000 individual student athletes during a 3-year career. Older athletes, particularly male joggers and marathon runners, however, have a much higher rate of exercise-related sudden death — reportedly approximately 1:30,000 per year. More than 90% of athletic field deaths occur in males and about 60% are at the median age of 17. Most important, Maron et al. indicated that the trigger for sudden death in athletes with unsuspected cardiac disease coincides with peak periods of competition training, particularly for organized team sports. In this setting, sudden death or major collapse has been associated with peak exercise training in 90% of athletes in the late afternoon and evening hours. This chapter deals mainly with sudden death in trained athletes, but similar deaths can occur in male high school students during training for team sports. The exact prevalence of this occurrence is unknown because of the lack of studies in this population group. The incidence of hypertrophic cardiomyopathy and other diseases discussed below should be similar in both trained and untrained athletes. Causes of sudden death in young athletes include:

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