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Athletes sudden cardiac death

Cesare de Gregorio, Dalia Di Nunzio, Gianluca Di Bella
Physical activity comprises all muscular activities that require energy expenditure. Regular sequence of structured and organized exercise with the specific purpose of improving wellness and athletic performance is defined as a sports activity.Exercise can be performed at various levels of intensity and duration. According to the social context and pathways, it can be recreational, occupational, and competitive. Therefore, the training burden varies inherently and the heart adaptation is challenging.Although a general agreement on the fact that sports practice leads to metabolic, functional and physical benefits, there is evidence that some athletes may be subjected to adverse outcomes...
March 13, 2018: Advances in Experimental Medicine and Biology
Cristina Basso, Kalliopi Pilichou, Barbara Bauce, Domenico Corrado, Gaetano Thiene
Arrhythmogenic cardiomyopathy (AC) is an inherited heart muscle disease characterized by myocardial atrophy and fibrofatty replacement of the ventricular myocardium, at risk of sudden cardiac death, particularly in the young and athletes. Because there is no "gold standard" to reach the diagnosis of AC, multiple categories of diagnostic information have been combined, including imaging, electrocardiographic changes, arrhythmias, tissue characterization, and family history. However, the routine use of contrast-enhanced cardiac magnetic resonance increasingly revealed left dominant AC, a variant that is not well addressed in the diagnostic criteria and still escapes clinical identification...
April 2018: Heart Failure Clinics
Mengye Li, Karan R Chadda, Gareth D K Matthews, Celia M Marr, Christopher L-H Huang, Kamalan Jeevaratnam
Exercising horses uniquely accommodate 7-8-fold increases in heart rate (HR). The present experiments for the first time analysed the related adaptations in action potential (AP) restitution properties recorded by in vivo telemetric electrocardiography from Thoroughbred horses. The horses were subjected to a period of acceleration from walk to canter. The QRS durations, and QT and TQ intervals yielded AP conduction velocities, AP durations (APDs) and diastolic intervals respectively. From these, indices of active, λ = QT/(QRS duration), and resting, λ0 = TQ/(QRS duration), AP wavelengths were calculated...
2018: PloS One
Andrea Silva, Maria João Baptista, Emanuel Araújo
Congenital coronary artery anomalies are modifications of their origin, course or structure and its incidence varies between 0,2 and 5,6% of the general population. Although the majority is asymptomatic, they are the second leading cause of sudden cardiac death in young athletes. The aim of this study is to highlight the main anomalies with hemodynamic significance, including the anomalous origin of a coronary artery from the opposite sinus and anomalous origin of the left coronary artery from pulmonary artery...
February 26, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Tamanna K Singh, Aaron L Baggish
Premature ventricular beats (PVBs) in competitive athletes are incidentally found during pre-participation ECG screening. Their clinical significance remains debatable with several studies suggesting they are a benign reflection of athlete's heart, and others proposing they may indicate underlying structural heart disease and heightened risk for sudden cardiac death (SCD). Areas covered: Effective management of athletes with PVBs may best be accomplished using an algorithmic approach for risk stratification with a goal of differentiating benign PVBs from those reflective of underlying cardiomyopathies...
February 23, 2018: Expert Review of Cardiovascular Therapy
Elena Vorona, Eberhard Nieschlag
Despite the fact that sports organizations and legislators have introduced various mechanisms to discourage athletes from using performance and appearance enhancing substances a high percentage of athletes admits to their unabated application. In competitive athletics, bodybuilding and in recreational sports anabolic androgenic steroids (AAS) continue to be the substances most abused. This review summarizes the side effects of AAS abuse on organs and system functions in both sexes. High doses of AAS cause a significant increase of erythrocytes und haemoglobin concentration, which may lead to thromboembolism, intracardiac thrombosis and stroke...
February 19, 2018: Minerva Endocrinologica
Amit Vora, Nitin Burkule, Ashish Contractor, Kartikeya Bhargava
The annual incidence of sudden cardiac death (SCD) in athletes is significantly lower than the general population. However, when SCD occurs in an athlete during sporting event or training, it sends shockwaves in the society and raises questions about cardiovascular effects of sports and exercise. This document reviews the causes and mechanism of SCD in sports and exercise in young and older athletes. In the Indian context, we suggest a 'pre-participation screening' of young and older athletes and consider a 'supervised, graded exercise regime' for the uninitiated, older sports participant...
January 2018: Indian Heart Journal
A Zorzi, A Pelliccia, D Corrado
Competitive sports activity is associated with an increased risk of sudden cardiovascular death in adolescents and young adults with inherited cardiomyopathies. Many young subjects aspire to continue competitive sport after a diagnosis of cardiomyopathy and the clinician is frequently confronted with the problem of eligibility and the request of designing specific exercise programs. Since inherited cardiomyopathies are the leading cause of sudden cardiovascular death during sports performance, a conservative approach implying disqualification of affected athletes from most competitive athletic disciplines is recommended by all the available international guidelines...
February 8, 2018: Netherlands Heart Journal
Rachel Lampert, Douglas P Zipes
Professional society recommendations to decrease sudden cardiac death in athletes, including eligibility requirements with disqualification for athletes with diagnosed disease as well as preparticipation screening and emergency preparedness, were updated in 2015. The update includes new sections on aortic disease, channelopathies, and sickle cell trait, as well as a change in format from the previous binary yes/no format to the more nuanced and contemporary "class and level of evidence" format. Eighty-four of the 246 recommendations now carry Class II designation-"reasonable," or "may be considered...
January 29, 2018: Annual Review of Medicine
Sabiha Gati, Sanjay Sharma, Dudley Pennell
Exercise-associated benefits on the cardiovascular systems are well established. Although exercise-associated sudden cardiac death is rare, most deaths in young athletes are due to hereditary or congenital cardiac diseases. Athletic adaptation itself is associated with several structural changes that overlap those observed in individuals with cardiomyopathies, often leading to dilemmas for the clinician regarding life-changing decisions including advice against competitive sports participation. Cardiac magnetic resonance plays an increasingly important role in helping to establish an accurate diagnosis in these individuals...
February 2018: JACC. Cardiovascular Imaging
David M Siebert, Jonathan A Drezner
Sudden cardiac arrest remains the leading cause of death in exercising athletes, and recent studies have shown that it occurs more frequently than historical estimates. While out-of-hospital cardiac arrest often proves fatal, advance preparation can improve outcomes and the chance of survival. First responders to a collapsed athlete on the field of play may include team medical personnel, coaches, other athletes, officials, venue staff, emergency medical services personnel, or lay bystanders. Prompt and accurate recognition of sudden cardiac arrest, a comprehensive and rehearsed emergency action plan, early cardiopulmonary resuscitation, and immediate access to and use of an automated external defibrillator are each pivotal links in the chain of survival...
February 6, 2018: Netherlands Heart Journal
Kyle P Lammlein, Jonathan M Stoddard, Francis G O'Connor
The most common cause of sudden cardiac death (SCD) in young athletes in the United States is "autopsy-negative sudden unexplained death." This makes it extremely difficult to screen for and diagnose predisposing cardiovascular conditions before athletic participation. The goal of the preparticipation physical examination is to detect risk factors for SCD, make risk-based decisions regarding the need for further workup, and ultimately recommend for or against participation. Current evidence recommends universal screening of young athletes using the 14-point American Heart Association preparticipation cardiovascular checklist...
March 2018: Primary Care
N M Panhuyzen-Goedkoop, H T Jørstad, J L R M Smeets
Sudden cardiac arrest or death (SCA/SCD) in athletes has a low event rate. Pre-participation or eligibility screening is a widely accepted method of primary prevention of SCA/SCD in athletes. Most European countries and international sports governing bodies perform ECG-inclusive screening. However, implementation of a resting 12-lead ECG in pre-participation or eligibility cardiac screening is still a topic of debate. Recently, the 'International recommendations for electrocardiographic interpretation in athletes' was published in three leading international medical journals...
February 1, 2018: Netherlands Heart Journal
Sofia Sunnerud, Eva Nylander, Magnus Janzon, Anna Carlén, Kristofer Hedman
Low adherence to recommended pre-participation cardiac evaluation of Swedish athletes Pre-participation cardiac evaluation of athletes is recommended by international organizations like the European Society of Cardiology and the American Heart Association, as well as by the Swedish Sports Confederation. The purpose of the evaluation is to prevent sudden cardiac death in athletes by early identification of individuals at risk. To our knowledge, no previous study has been made regarding the implementation of pre-participation cardiac evaluation of athletes in Sweden...
January 30, 2018: Läkartidningen
Moacir Marocolo, Julio A Silva-Neto, Octávio Barbosa Neto
Anabolic androgenic steroids are a class of synthetic compounds derived from testosterone, eventually used by athletes, to improve physical performance. However, anabolic steroids can also modify normal cardiovascular function. Thus, we investigated cardiac electrophysiological and autonomic abnormalities in rats, through a electrocardiographic variability protocol during and after interruption of administration of nandrolone decanoate (DECA)anabolic steroid. Twenty male Wistar rats (60-70 days old) received DECA (10 mg...
January 20, 2018: Steroids
Hélder Dores, Pedro de Araújo Gonçalves, Nuno Cardim, Nuno Neuparth
Regular physical exercise is responsible for various health benefits, and is recommended for primary and secondary cardiovascular (CV) prevention. Despite these recognized benefits, various clinical events can occur in athletes, including acute myocardial infarction and sudden cardiac death (SCD); the main cause of SCD in veteran athletes is coronary artery disease (CAD). The relationship between intense exercise training and CAD is controversial, and a U-shaped association has been hypothesized. If this is the case, screening for subclinical CAD in older athletes may be justified, and various different methodologies have been proposed...
January 8, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Michael S Emery, Richard J Kovacs
Sudden cardiac death is a tragedy at any age and under any circumstances but is perhaps most tragic when it claims the life of the athlete, the individual who epitomizes health and a healthy lifestyle. Sports cardiologists from around the world have worked to quantitate the incidence of sudden cardiac death (SCD) in the athlete, to identify risk factors, to develop pre-participation screening tools, and to formulate plans to deal with on-field SCD. Progress has been made, but much remains to be done in order to make both competitive and recreational sports safer for both patients with known cardiac disease and athletes without known or suspected cardiac abnormalities...
January 2018: JACC. Heart Failure
Y Cao, P-Y Zhang
Hypertrophic cardiomyopathy (HCM) is a complex but common monogenic cardiovascular disorder characterized by unexplained non dilated left ventricular (LV) thickening in the absence of another cardiac or systemic disease. The condition is associated with sudden and unexpected death in young individuals including trained athletes. HCM represents a genetic disorder caused by mutations in genes encoding sarcomeric proteins of the cardiac myocyte. This review article discusses the genetics behind HCM, its clinical presentation, and diagnosis and the present-day pharmacological management of HCM...
November 2017: European Review for Medical and Pharmacological Sciences
Kadir Uğur Mert, Ferhat Radi, Ayda Sadati, Gurbet Özge Mert, Muhammet Dural
OBJECTIVE: Sudden cardiac death in athletes is one of the most tragic health events seen both in our country and all over the world. In some of those athletes, there is no obvious structural abnormality. Dynamic changes in intracardiac hemodynamics during exercise may be a cause for sudden death in these athletes, the impact of exercise on intracardiac gradient and cardiac hemodynamic parameters in athletes was compared with healthy controls. METHODS: A total of 21 professional male athletes and 21 healthy male controls were included in the study...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
N M Panhuyzen-Goedkoop, H J Wellens, J J Piek
INTRODUCTION: Sudden cardiac arrest (SCA) in athletes is an unexpected life-threatening event, which is often not recognised early and cardiopulmonary resuscitation (CPR) is not always initiated immediately. We describe key features to rapidly recognise non-traumatic SCA in athletes during sports activity. METHODS: We reviewed videos and images of athletes suffering from non-traumatic SCA during sports activity. We searched Google images, Google videos and YouTube...
January 2018: Netherlands Heart Journal
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