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Sudden Deaths In Athletes

Written by Patti Beggs, ATC
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While sudden cardiac death in athletes has become a popular topic in the news, it is not the only cause for sudden death in athletes.  Sudden cardiac deaths in NCAA athletes account for 16% of deaths, which is a small number in reality.  Due to the uncertainty and the nature of sudden cardiac deaths, we are left with a lot of unanswered questions.  This is why when a death caused by a sudden cardiac event occurs; the media tends to be quick to report about it.

The most common causes of sudden cardiac death include genetic/congenital anomaly, myocarditis, commotio cordis, and coronary artery disease.  The most prevalent cardiac condition in the United States is reported to be Hypertrophic Cardiomyopathy.  Hypertrophic Cardiomyopathy (HCM) affects 1/500 people and is the thickening of the myocardium causing stiffness in the left ventricle, mitral valve changes and cellular disorganization.  Signs and symptoms of HCM include chest pain with activity, shortness of breath, fatigue with exertion, syncope (fainting), chest palpitations and sudden death.

Early recognition and knowledge of signs/symptoms of cardiac arrest are two very important preventative techniques.  Other preventative measures include Electrocardiogram, which is a test that checks for problems with the electrical activity of your heart. While it is not required in the US for an athlete to have an EKG before participating in a sport, some believe that this alone could help identify abnormalities, thus preventing sudden death related to cardiac conditions. 

Even if an EKG is conducted on an athlete as part of their pre-participation, the United States does not require a specialist to read the EKGs, which may lead to missed diagnosis.  In Italy, where Arrythmogenic Right Ventricular Cardiomyopathy (ARVS) is more prevalent, it is required for all athletes to undergo an EKG before participation and the results are read by a specialist in order to prevent errors. 

Pre-participation physicals are required for an athlete to compete in athletics at any level.  The problem with these pre-participation physicals lies with who is conducting the physical.  It is suggested that the athlete’s primary healthcare provider (PCP) be the one to conduct the exam due to knowledge of patient’s past history and time the PCP will spend  with the patient.   Whereas, a scheduled pre-participation exam at the athlete’s high school may be conducted by a doctor that the athlete has never met, with no history of the patient and take less than five minutes to complete the exam, making it hard to identify “red flags” the athlete may have.

One other important preventative measure that can help decrease the amount of sudden death in athletes is for the school/organization to have an Athletic Trainer on staff.  Athletic Trainers are educated in emergency care of athletes and are aware of the signs/symptoms of conditions, such as a sudden cardiac event, and the treatment of such conditions.  Other causes of sudden death in athletes include exertional sickeling, exertional heat stroke and traumatic spine or brain injury. 

As previously stated, Athletic Trainers have the knowledge of each of these conditions and are equipped with the proper medical supplies (i.e, AED, CPR certification, Concussion guideline, heat index charts, Emergency Action Plan, etc.) in order to handle an emergency situation.  It is important to know the conditions of the environment and the background of the athlete (asthmatic, allergies, temperature, field status etc.) in order to help prevent emergency events from taking place.  Each state has criteria that schools must follow in order to keep athletes safe, which is usually carried out by an Athletic Trainer.

Preparedness and prevention are the two most important points to take from this blog.  It is always good to seek out information about a condition that you may know little about, but make sure that the information is relevant and accurate.  

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