Sudden death and cardiac arrest
Sudden death and cardiac arrest in athletes
Some facts are already known about sudden death (SD) in athletes. The incidence of SD in young athletes is 0.5 to 3 per 100,000 per year and this rises from the age 35 onwards. The risk of SD is dependent on gender (in about 90% of cases the athletes affected are men), age (most common in 40- to 50-year-olds) and exercise intensity (higher risk at higher exercise intensities). Most non-traumatic deaths in sport are attributed to cardiovascular abnormalities. In young athletes under 35 years of age, hypertrophic cardiomyopathy (HCM), coronary anomalies, myocarditis and arrhythmogenic right ventricular cardiomyopathy (ARVC) are the leading causes of cardiac arrest. Coronary artery disease (CAD) accounts for the vast majority of fatalities in athletes aged over 35 years. In 2 to 5% of cases, there is no evidence of structural heart diseases. The cause of these cardiac arrests is most likely related to a primary electrical heart disease such as inherited cardiac ion channel defects (channelopathies), including long and short QT syndromes, Brugada syndrome and polymorphic ventricular tachycardia.
The distribution of the different cardiac diseases seems to vary across different regions and the role of ethnicity is not fully understood.