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Athletes sudden cardiac death

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https://www.readbyqxmd.com/read/28220574/selective-use-of-the-electrocardiogram-in-pediatric-preparticipation-athletic-examinations-among-pediatric-primary-care-providers
#1
Bradley C Clark, Joshua M Hayman, Charles I Berul, Kristin M Burns, Jonathan R Kaltman
OBJECTIVES: Recent literature examining insurance administrative data suggests that a selective approach, with concurrent history and physical exam (H&P), for obtaining an electrocardiogram (ECG) as a part of a preparticipation examination (PPE) for pediatric athletes is commonly used in the primary care setting demonstrating a high rate of disease detection. We sought to understand practice patterns of providers with regard to usage of ECG as a part of PPE. METHODS: Utilizing an online survey, we queried primary care providers regarding their practice patterns, rationale, and concerns regarding use of ECGs as a part of the PPE...
February 21, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28194680/parental-knowledge-of-cardiovascular-screening-and-prevention-of-sudden-cardiac-arrest-in-youth-athletes
#2
Madison A Wagener, Alex B Diamond, Ashley Rowatt Karpinos
Sudden cardiac arrest (SCA) is the leading cause of death in youth athletes. Survival from out- of-hospital SCA depends on prompt initiation of cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED). This study evaluated parental knowledge, experience, and attitudes related to cardiovascular screening, SCA, and CPR/AED use in youth athletes and made comparisons between parents who are employed in healthcare and parents who are not employed in healthcare. We conducted a cross-sectional survey to evaluate knowledge, experiences, and attitudes of 91 parents of youth athletes who attended a community-based cardiovascular screening event...
February 13, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28193509/pilot-study-analyzing-automated-ecg-screening-of-hypertrophic-cardiomyopathy
#3
Matthew Campbell, Xuefu Zhou, Chia Han, Hedayat Abrishami, Gregory Webster, Christina Y Miyake, Christopher T Sower, Jeffery B Anderson, Timothy K Knilans, Richard J Czosek
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is one of the leading causes of sudden cardiac death in athletes. However, pre-participation ECG screening has often been criticized for failing to meet cost-effectiveness thresholds, in part because of high false-positive rates and the cost of ECG screening itself. OBJECTIVES: To assess the testing characteristics of an automated ECG algorithm designed to screen for HCM in a multi-institutional pediatric cohort. METHODS: ECGs from patients with HCM aged 12 - 20 years from 3 pediatric institutions were screened for ECG criteria for HCM using a previously described automated computer algorithm developed specifically for HCM ECG screening...
February 10, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28140625/ncaa-football-off-season-training-unanswered-prayers%C3%A2-a-prayer-answered
#4
Scott Anderson
Off-season training in year-round collegiate football is purported to be performance enhancing. Absent principles of exercise physiology, excesses in sport-training regimens pose risk to the participant athletes. Since 2000, 32 National Collegiate Athletic Association (NCAA) football players have died in sport: 26 nontraumatic deaths and 6 traumatic deaths, a ratio of more than 4 nontraumatic deaths for every traumatic death. On average, 2 NCAA football players die per season played. Best practices, consensus guidelines, and precautions are ignored, elevating the risk...
January 31, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28116464/-sports-cardiology-overview-of-relevant-clinical-topics
#5
R Laszlo, J Scharhag, C Burgstahler, H Striegel, J M Steinacker
Physical activity is nowadays an established therapeutic principle concerning primary and secondary prevention of cardiovascular diseases; therefore, in internal sports medicine various aspects go beyond basic cardiological knowledge and require special medical expertise (sports cardiology). Acute cardiac risk is increased during physical activity; therefore, physical activity should be individually phased under consideration of the whole clinical situation. Physical training results in a functional adaptation of the cardiovascular system...
January 23, 2017: Herz
https://www.readbyqxmd.com/read/28092299/the-complex-phenotype-of-the-athletes-heart-implications-for-pre-participation-screening
#6
Benjamin Brown, Daniel J Green, Matthew Wilson, Jonathan Drezner, Keith George, David Oxborough
Pre-participation screening is vital to exclude inherited cardiac conditions which have the potential to cause sudden cardiac death in seemingly healthy athletes. Recent research has questioned traditional theories of load-induced, dichotomous cardiac adaptation. We therefore considered whether a "one-size-fits-all" approach to screening can account for inter-individual differences brought about by sporting discipline, training volume, ethnicity, body size, sex and age.
January 13, 2017: Exercise and Sport Sciences Reviews
https://www.readbyqxmd.com/read/28049727/allosteric-transmission-along-a-loosely-structured-backbone-allows-a-cardiac-troponin-c-mutant-to-function-with-only-one-ca-2-ion
#7
Mayra de A Marques, Jose Renato Pinto, Adolfo H Moraes, Anwar Iqbal, Mariana T Q de Magalhães, Jamila Monteiro, Murilo M Pedrote, Martha M Sorenson, Jerson L Silva, Guilherme A P de Oliveira
Hypertrophic cardiomyopathy (HCM) is one of the most common cardiomyopathies and a major cause of sudden death in young athletes. The Ca(2+) sensor of the sarcomere, cardiac troponin C (cTnC), plays an important role in regulating muscle contraction. Although several cardiomyopathy-causing mutations have been identified in cTnC, the limited information about their structural defects has been mapped to the HCM phenotype. Here, we used high-resolution electron-spray ionization mass spectrometry (ESI-MS), Carr-Purcell-Meiboom-Gill relaxation dispersion (CPMG-RD), and affinity measurements of cTnC for the thin filament in reconstituted papillary muscles to provide evidence of an allosteric mechanism in mutant cTnC that may play a role to the HCM phenotype...
February 10, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/27996994/-sudden-cardiac-arrest-in-italian-sports-facilities-in-2015-epidemiological-implications-of-the-so-called-balduzzi-decree
#8
Alessandro Zorzi, Angela Susana, Veronica Spadotto, Luisa Cacciavillani, Domenico Corrado
Under the Italian Law "Legge Balduzzi", which was issued after the sudden cardiac death of professional athletes Pier Mario Morosini and Vigor Bovolenta in 2012, the presence of an automated external defibrillator (AED) and personnel trained to perform cardiopulmonary resuscitation must be available in every Italian sports facility from 2016. In 2015 the national and local press reported 123 cases of sudden cardiac arrests (SCA) occurring in Italian sport facilities, corresponding to an estimated ≈0.2-0.4% of all SCA and to ≈0...
November 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27926615/coronary-artery-evaluation-by-screening-echocardiogram-in-intercollegiate-athletes
#9
Walter J Hoyt, Peter N Dean, Daniel S Schneider, Mark R Conaway, Christopher M Kramer, Robert W Battle
INTRODUCTION: Coronary artery anomalies are the second most common congenital cause of sudden cardiac death (SCD) in young athletes. Some centers have advocated for limited transthoracic echocardiogram (TTE) protocols in the screening of college athletes, which may miss important causes of SCD. PURPOSE: The purpose of this study is to evaluate the ability of screening TTE to determine origin and proximal course of the coronary arteries in intercollegiate athletes...
December 6, 2016: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/27910804/sudden-cardiac-death-a-nationwide-cohort-study-among-the-young
#10
Bjarke Risgaard
Sudden cardiac death (SCD) is a tragic event affecting millions of individuals worldwide. Although several studies have investigated the epidemiology of SCD, these studies may have been affected by reporting and referral biases, which are reflected in the very different incidence rates and causes of deaths that have previously been reported. Among SCD victims aged < 36 years, inherited cardiac diseases are well known to play an important role. However, the extent to which inherited cardiac diseases also play a role in SCD victims aged < 50 years has not been completely described...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27882733/anomalous-origin-of-the-right-coronary-artery-first-familial-cases-in-asia
#11
Hideki Motomura, Mari Yokokawa, Hirofumi Fukunaga, Mari Nakagaki, Tomoyuki Hasuwa, Hiroyuki Moriuchi
Congenital coronary artery abnormalities may cause sudden death, particularly in athletes. Two siblings, aged 10 and 9 years, respectively, were diagnosed with anomalous origin of the right coronary artery on multi-detector computed tomography (MDCT). The right coronary artery arose from the left coronary cusp, and was wedged between the aorta and pulmonary artery. This was also noted on cardiac ultrasonography (UCG), but in general this might not be seen on electrocardiography at rest. Although the surgical indications are unclear in the case of unproven ischemia, early recognition of the condition may reduce risk of the cardiac events during exercise...
November 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27830773/grey-zones-in-cardiomyopathies-defining-boundaries-between-genetic-and-iatrogenic-disease
#12
REVIEW
Giovanni Quarta, Michael Papadakis, Paolo Di Donna, Niccolò Maurizi, Attilio Iacovoni, Antonello Gavazzi, Michele Senni, Iacopo Olivotto
Genetic cardiomyopathies are complex diseases with heterogeneous clinical presentation and phenotypes. Early descriptions of cardiomyopathies originated from case studies involving individuals with severe, paradigmatic presentation, which provided insight into the worst-case scenarios of these conditions. With time, improved diagnostic sensitivity and awareness of cardiomyopathies has uncovered a more heterogeneous disease spectrum, including mild phenotypes overlapping with physiological variation. This diagnostic 'grey area' poses important dilemmas, particularly in athletes...
November 10, 2016: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27755012/early-screening-for-cardiovascular-abnormalities-with-preparticipation-echocardiography-feasibility-study
#13
Courtney N Gleason, Deanna L Kerkhof, Elizabeth A Cilia, Maria A Lanyi, Jonathan Finnoff, Dai Sugimoto, Gianmichel D Corrado
OBJECTIVE: The traditional history and physical (H&P) is a poor screening modality to identify athletes at risk for sudden cardiac death. Although better than H&P alone, electrocardiograms (ECG) have also been found to have high false-positive rates. A limited portable ECG by a frontline physician (PEFP) performed during preparticipation physical examination (PPE) allows for direct measurements of the heart to more accurately identify athletes with structural abnormalities. Therefore, it is worthwhile to assess the feasibility of incorporating limited PEFP as part of PPEs...
October 13, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/27751241/decision-analysis-to-define-the-optimal-management-of-athletes-with-anomalous-aortic-origin-of-a-coronary-artery
#14
Carlos M Mery, Keila N Lopez, Silvana Molossi, S Kristen Sexson-Tejtel, Rajesh Krishnamurthy, E Dean McKenzie, Charles D Fraser, Scott B Cantor
OBJECTIVES: The goal of this study was to use decision analysis to evaluate the impact of varying uncertainties on the outcomes of patients with anomalous aortic origin of a coronary artery. METHODS: Two separate decision analysis models were created: one for anomalous left coronary artery (ALCA) and one for anomalous right coronary artery (ARCA). Three strategies were compared: observation, exercise restriction, and surgery. Probabilities and health utilities were estimated on the basis of existing literature...
November 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27720455/myocardial-fibrosis-in-athletes
#15
REVIEW
Freek R van de Schoor, Vincent L Aengevaeren, Maria T E Hopman, David L Oxborough, Keith P George, Paul D Thompson, Thijs M H Eijsvogels
Myocardial fibrosis (MF) is a common phenomenon in the late stages of diverse cardiac diseases and is a predictive factor for sudden cardiac death. Myocardial fibrosis detected by magnetic resonance imaging has also been reported in athletes. Regular exercise improves cardiovascular health, but there may be a limit of benefit in the exercise dose-response relationship. Intense exercise training could induce pathologic cardiac remodeling, ultimately leading to MF, but the clinical implications of MF in athletes are unknown...
November 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27692971/incidence-and-etiology-of-sudden-cardiac-arrest-and-death-in-high-school-athletes-in-the-united-states
#16
Kimberly G Harmon, Irfan M Asif, Joseph J Maleszewski, David S Owens, Jordan M Prutkin, Jack C Salerno, Monica L Zigman, Rachel Ellenbogen, Ashwin L Rao, Michael J Ackerman, Jonathan A Drezner
OBJECTIVE: To determine the incidence and etiology of sudden cardiac arrest and death (SCA/D) in US high school athletes. PATIENTS AND METHODS: A prospective media database of SCA/D was queried for cases aged 14 to 18 years from 7 states over 6 school years (September 1, 2007, to August 30, 2013). Event details were investigated to determine participation on a high school athletic team, sex, sport, and occurrence during school-sponsored activity or exertion. National sports participation numbers were used and a conversion factor was applied to account for multisport athletes...
November 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27692657/detecting-underlying-cardiovascular-disease-in-young-competitive-athletes
#17
James McKinney, Daniel J Lithwick, Barbara N Morrison, Hamed Nazzari, Michael Luong, Christopher B Fordyce, Jack Taunton, Andrew D Krahn, Brett Heilbron, Saul Isserow
BACKGROUND: Sudden cardiac death (SCD) is frequently the first manifestation of underlying cardiovascular disease in young competitive athletes (YCAs), yet there are no Canadian guidelines for preparticipation screening in this population. The goal of this study was to determine the prevalence of potentially lethal cardiovascular disease in a sample of Canadian YCAs by comparing 2 screening strategies. METHODS: We prospectively screened 1419 YCAs in British Columbia, Canada (age 12-35 years)...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27692227/exercise-prescription-for-the-athlete-with-cardiomyopathy
#18
REVIEW
Sara Saberi, Sharlene M Day
Inherited cardiomyopathies have highly variable expression in terms of symptoms, functional limitations, and disease severity. Associated risk of sudden cardiac death is also variable. International guidelines currently recommend restriction of all athletes with cardiomyopathy from participation in competitive sports. While the guidelines are necessarily conservative because predictive risk factors for exercise-triggered SCD have not been clearly identified, the risk is clearly not uniform across all athletes and all sports...
November 2016: Cardiology Clinics
https://www.readbyqxmd.com/read/27692223/using-the-12-lead-electrocardiogram-in-the-care-of-athletic-patients
#19
REVIEW
Tee Joo Yeo, Sanjay Sharma
This article summarizes the role of the 12-lead electrocardiogram (ECG) for the clinical care of athletes, with particular reference to the influence of age, gender, ethnicity, and type of sport on the appearance of the ECG, and its role in differentiating physiologic exercise-related changes from pathologic conditions implicated in sudden cardiac death (SCD). The article also explores the potential role of the ECG in detecting athletes at risk of SCD. In addition, the article reviews the evolution of ECG interpretation criteria and emphasizes the limitations of the ECG as well as the potential for future research...
November 2016: Cardiology Clinics
https://www.readbyqxmd.com/read/27692222/sudden-cardiac-death-in-athletes-still-much-to-learn
#20
REVIEW
Joanna Sweeting, Christopher Semsarian
Athletes are often regarded as individuals at the pinnacle of health and fitness, nearly to the point of invincibility. The sudden cardiac death (SCD) of an athlete is therefore generally unexpected and extremely traumatic. Some of the most commonly identified causes of SCD in athletes include the genetic heart diseases. Despite thorough clinical and genetic investigation, in some cases a cause of death cannot be elucidated. Further research in these areas, spanning clinical, genetic, and public health perspectives, is required to help guide clinicians and those encountering the tragedy of SCD in an athlete...
November 2016: Cardiology Clinics
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