According to a study in Italy by Corrado D et al, the rate of mortality due to sudden cardiac death was reduced in athletes by 90% after screening all with pre-participation history and physicals plus electrocardiogram (EKG) then additional testing with echocardiogram and other directed testing based on positive findings. An electrocardiogram (EKG) was found by the authors to have adequate sensitivity and specificity for detecting cardiomyopathy and a future possibility of arrythmias. (57)
Specific problems which are associated with sudden cardiac arrest (58,59):
- Hypertrophic cardiomyopathy is an abnormal thickening of the cardiac musculature which may result in result in ventricular arrhythmias such as ventricular tachycardia or ventricular fibrillation during activity and is the most common cause of death in the young athlete under 30 years old.
- Coronary artery anomalies (or malformation of coronary vessels) is a congenital abnormality that may result in collapse of the artery during activity.
- Prolonged QT (or Long QT) syndrome may be inherited and result in ventricular arrhythmias such as ventricular tachycardia or ventricular fibrillation.
- A viral infection of the heart may increase risk of ventricular arrhythmias. Other structural heart abnormalities may result in SCD.
- Another rare cause is called commotio cordis when SCD can occur if a blunt force to the heart during sports occurs at a specific moment during electrical conduction which results in ventricular fibrillation.
ACC/AHA/ESC published basic guidelines for the prevention of sudden cardiac death (SCD):
The American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee (ACC/AHA/ESC) published guidelines for the prevention of sudden cardiac death (SCD). The SCD of young athletes is rare, but electrocardiogram (EKG) is usually indicated prior to competitive sports and may reveal abnormalities. An echocardiogram may also be considered prior to participation in competitive sports. (59)