Sudden Cardiac Death in Sport

Sudden Cardiac Death in Sport        
Prepared by  Prepared by: Dr Ralph Richards, Senior Research Consultant, Clearinghouse for Sport, Australian Sports Commission
Last updated  Last updated: 6 January 2017
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Physical Literacy and Sport
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Introduction

Although not a universally accepted definition, Sudden Cardiac Death (SCD) can be considered a nontraumatic, nonviolent, unexpected death due to cardiac causes within 1 hour of the onset of symptoms (Koester, 2001). This is also known as Sudden Arrhythmic Death Syndrome (SADS). The most common cause of this kind of sudden death is hypertrophic cardiomyopathy (HCM).

  • Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology (PDF  - 255 KB), Thompson P, Franklin B, Balady G, Blair S, Corrado D, Estes N, Fulton J, Gordon N, Haskell W, Link M, Maron B, Mittleman M, Pelliccia A, Wegner N, Willich S and Costa F, Circulation, Volume 115, Issue 17 (2007). Substantial evidence supports the relationship between habitual physical activity and a reduction in coronary heart disease events, but vigorous activity can also acutely and transiently increase the risk of sudden cardiac death and acute myocardial infarction in susceptible persons. This scientific statement discusses the potential cardiovascular complications of exercise, their pathological substrate, and their incidence and suggests strategies to reduce these complications. Exercise-associated acute cardiac events generally occur in individuals with structural cardiac disease. Hereditary or congenital cardiovascular abnormalities are predominantly responsible for cardiac events among young individuals, whereas atherosclerotic disease is primarily responsible for these events in adults. The absolute rate of exercise-related sudden cardiac death varies with the prevalence of disease in the population. The incidence of both acute myocardial infarction and sudden death is greatest in those individuals who are less physically active during their lifetime. Maintaining physical fitness through regular physical activity may help to reduce cardiac events because a disproportionate number of events occur in least physically active subjects performing unaccustomed physical activity. One estimate of exercise induced death among high school and college athletes in the United States was one per 133,000 men and one per 769,000 women, but the rate may vary by sport. The incidence of sudden cardiac death among the general population may be several times the rate observed among athletes. Although vigorous exercise may increase the risk of a cardiovascular event during or soon after exertion in both young subjects with inherited cardiovascular disease and adults with occult or diagnosed cardiac disease; there is no evidence to suggest that the risks of physical activity outweigh the benefits for healthy subjects. Indeed, the converse appears to be true.

Key Messages 

1

Unexpected death due to cardiac causes is an infrequent occurrence in sport; however, understanding the risk factors and management practices will help to frame appropriate policies and actions.




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