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More Athletes With Sudden Cardiac Death Than Previously Thought

Approximately 1 in every 44,000 thousand athletes in the USA dies from sudden cardiac death in the USA each year, a significantly higher rate than previously thought, Kimberly Harmon, M.D. explained in the journal Circulation. Harmon believes their team's finding may have an impact on health screening guidelines for young people in organized sports.

Among athletes with underlying heart disease, such as hypertrophic cardiomyopathy, sports training and competitive events can significantly increase the chances of sudden cardiac death, according to the American Heart Association.

Dr. Kimberly Harmon, of University of Washington, explains that sudden cardiac death estimates among athletes have been based on tenuous data sources, such as media reports. Other sources, including some studies, do not have reliable figures regarding how many people practice sports in general in the USA.

This latest research used insurance claims, data from the NCAA (National Collegiate Athletic Association), and news reports. The NCAA has annual data on 400,000 students aged between 17 and 23.

Through the period 2004 to the end of 2008, their researchers found that:

There were 273 deaths from any cause
187 athletes (68% of them) died from non-medical, non-traumatic causes
80 athletes (29% of them) died from medical causes
6 athletes (2% of them) died from unknown causes
45 athletes (56%) of those who died from medical causes did so because of a cardiovascular-related sudden death. 75% (27 athletes) of the 36 who died during or just after exertion were related to cardiac causes.

They worked out that:

Overall, 1 in every 43,770 athletes died each year of sudden cardiac death
1 in every 17,696 African-American athletes had a sudden cardiac death each year
1 in every 58,653 Caucasian athletes had a sudden cardiac death annually
1 in every 11,394 competitive basketball players died of sudden cardiac death each year. The sport with the highest proportion of deaths.
1 in every 3,000 male basketball athletes in Division I died of sudden cardiac death annually
Competitive swimming had the second highest risk of sudden cardiac death, followed by lacrosse, football and cross-country track.
Dr. Harmon, who is a team doctor at the University of Washington, explains that sudden cardiac death rates in various sports determine whether young athletes should be screened with an electrocardiogram or echocardiogram. Harmon said:

"You have to revisit the whole question of whether a more extensive screening makes sense in light of these new numbers. The question is: where do you set the risk cutoff - one in 10,000, or 40,000, or 100,000?"

Before any athlete engages in competitive training and sporting events, they should give a detailed personal and family medical history as well as undergo a thorough physical exam. If anything of concern is found, or any information raises concern, further testing should occur, according to a 2007 American Heart Association statement.

In Europe, unlike the USA, the European Society of Cardiology recommends that electrocardiograms (ECG) be used routinely. The American Heart Association panel decided this was "unwieldy and too costly for large U.S. athlete populations.".

Ralph L. Sacco, M.S., M.D., President, the American Heart Association, said:

"The American Heart Association regards cardiovascular screening for athletes as an important public health issue, for which there are compelling ethical, legal and medical grounds. We strongly encourage student-athletes and other participants in organized competitive sports to be screened with a careful history, including family history, and thorough physical examination. The American Heart Association also believes healthcare professionals providing the screening should be able to order noninvasive testing when they judge it is needed."

Harmon believes more thorough screening would be practical if it were targeted at basketball players and other high-risk groups. Automated external defibrillators should be routinely strategically placed at high-risk sporting event venues.

'Incidence of Sudden Cardiac Death in National Collegiate Athletic Association Athletes"
Kimberly G. Harmon, MD; Irfan M. Asif, MD; David Klossner, ATC, PhD Jonathan A. Drezner, MD
Circulation. 2011;0:CIRCULATIONAHA.110.004622.

Written by Christian Nordqvist 
Copyright: Medical News Today

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