The incidence of sudden death in athletes

Abstract

The incidence of sudden death is 4 fold greater in athletes than in their nonathletic counterparts due to a quiescent cardiac abnormality predisposing to life threatening arrhythmia. The most common cause of sudden cardiac death in younger athletes are genetic disorders like hypertrophic or arrhythmogenic cardiomyopathy and coronary artery anomalies whereas in older athletes – atherosclerotic coronary artery disease. There are some indications that excessive endurance exercise may be itself potentially harmful causing myocardial remodeling affecting the right ventricle and resulting in proarrhythmic effect of damaged myocardium. Endurance sport may increase a risk of coronary events. Preparticipation screening protocol encompassing  electrocardiogramis is recommended. ECG improves efficacy in detection of conditions capable of causing sudden death in sport. Disqualification of athletes affected by life threatening heart diseases significantly decreases risk of sudden cardiac death.