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Sudden cardiac death and athletes
Sudden cardiac death
(SCD) occurs rarely in athletes, but when it does happen, it often
affects the wider community.
Cause:
Most cases of SCD are related to undetected cardiovascular disease.
In the younger population, SCD is often due to congenital heart
defects, while in older athletes (35 years and older), the cause is more
often related to coronary artery disease.
Prevalence:
Although SCD in athletes is rare, media coverage often makes it seem
like it is more prevalent. In the younger population, most SCD occurs
while playing team sports; in about one in 100,000 to one in 300,000
athletes, and more often in males. In older athletes (35 years and
older), SCD occurs more often while running or jogging – in about
one in 15,000 joggers and one in 50,000 marathon runners.
Screening:
The American Heart Association recommends cardiovascular
screening for secondary school and college athletes, which should
include a complete and careful evaluation of the athlete’s personal and
family history and a physical exam. A history should be obtained
every year. Further investigation such as an echocardiogram or
exercise stress test may be needed.
If heart problems are identified or suspected, the athlete should be
referred to a cardiologist for further evaluation and treatment
guidelines before taking part in the sport.
Implantable cardioverter-defibrillator
For patients who have a very high risk for SCD, an ICD may
be inserted as a preventive treatment. An ICD is a small
machine similar to a pacemaker that is designed to correct
arrhythmias. It detects and then corrects a fast heart rate.
Interventional procedures or surgery:
For patients with coronary artery disease, an interventional
procedure such as angioplasty or stent placement may be
needed to improve blood flow to the heart muscle and reduce
the risk of SCD. For patients with other conditions, such as
hypertrophic cardiomyopathy or congenital heart defects, an
interventional procedure or surgery may be needed to correct
the problem. Other procedures may be used to treat abnormal
heart rhythms, including electrical cardioversion and catheter
ablation.
What is the treatment for sudden cardiac
arrest?
Sudden cardiac arrest can be treated and reversed, but
emergency action must take place immediately. Survival can
be as high as 90 percent if treatment is initiated within the
first minutes after sudden cardiac arrest. The rate decreases by
about 10 percent each minute longer. Those who survive have
a good long-term outlook.
9-9-9
If you witness someone experiencing sudden cardiac arrest,
immediately dial 9-9-9 or call your local emergency
personnel and initiate CPR. If done properly, CPR can save a
person’s life, as the procedure keeps blood and oxygen
circulating through the body until help arrives.
If an AED (Ambulatory External Defibrillator) is available,
the best chance of rescuing the patient includes defibrillation
with that device. The shorter the time until defibrillation, the
greater the chance the patient will survive. It is CPR plus
defibrillation that rescues the patient.
Once emergency personnel arrive, defibrillation can be used
to restart the heart. This is done through an electric shock
delivered to the heart through paddles placed on the chest.
After successful defibrillation, most patients require hospital
care to treat and prevent future cardiac problems.