Sudden Cardiac Death in sports: What is at stake?

The aim of this study was to concentrate exclusively on the cardiac risk factors, since most cases of sudden death are triggered by underlying cardiac abnormalities that have nothing to do with doping issues. The most common causes of sudden cardiac death in young athletes (aged 12-35) are reported to be cardiomyopathies, congenital, arrhythmias, degenerative, infectious, atherosclerotic and trauma.

Sudden death has been defined by various authors. The definition used for this study is the definition adopted by the IOC consensus meeting on Sudden Death held the 9-10th December 2004:

Sudden Cardiac Death = 'Death occurring within one hour of the onset of symptoms in a person without previously recognized cardiovascular condition that would appear fatal: this excludes cerebrovascular, respiratory, traumatic and drug related causes'.

The aim of this study was to concentrate exclusively on the cardiac risk factors, since most cases of sudden death are triggered by underlying cardiac abnormalities that have nothing to do with doping issues. The most common causes of sudden cardiac death in young athletes (aged 12-35) are reported to be cardiomyopathies, congenital, arrhythmias, degenerative, infectious, atherosclerotic and trauma. 

Content of results:
Incidence of sudden cardiac death
Causes of sudden cardiac death
Sports with highest risk of sudden death
Age of sudden death
Sport organizations
Screening tests
Lausanne Recommendations
Cost effectiveness

Conclusions: 
SCD in athletes is a tragic event. However, the causes of SCD of young competitive athletes is better understood now. Undetected cardiopathies, even those of a minor order, pose a significant risk for sudden death in athletes. They can be detected by preparticipation screening programs. Even if the detection will never completely eradicate the sudden deaths in sport they can reduce the risk for people with a cardiac defect, without excluding from sports participation athletes with an adapted heart. Some sports with high demands for the cardiovascular system put athletes with a heart defect even more at risk for sudden death.

That is why the IOC adopted a screening program (The Lausanne Recommendations). The Lausanne Recommendations is aimed at safety and can be performed at a tolerable cost. It should be recommended and used by as many countries as possible worldwide. Other progrma are already in the process of being adopted (i.e. proposal for a European Protocol).

The FIFA and the UCI fully endorse the Lausanne Recommendations.

Despite all thes positive notes a thorough inventory of all occurring sudden death during sport by either sport organizations or countries remains a priority in order to identify the real extend of the problem.