BENGALURU: Exercise is one of the most powerful tools for improving health and has been associated with a beneficial change in most cardiovascular risk factors, including lipids, blood pressure, insulin sensitivity, and weight. However, for a small number of individuals who harbour cardiac conditions, exercise can sometimes be associated with the risk of sudden death. Sudden cardiac death (SCD) is the most frequent medical cause of sudden death in athletes, and estimates vary widely based on the population.
SCD is a sudden, unexpected death caused by loss of heart function. This results from intense physical exercise in the context of an underlying cardiovascular abnormality. 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. Studies pin the number as around 1 in 40,000 to 1 in 80,000 athletes per year suffer from this condition.
In 50% of the cases, a racing heartbeat or dizziness is the most common symptom. In remaining cases, symptoms may not even appear. Victims of SCD are often entirely asymptomatic before their initial presentation and demonstrate only subtle abnormalities on investigation. It is therefore recommended that cardiac evaluation of an athlete is performed by trained cardiologists and sports physicians familiar with the conditions capable of causing SCD.
In younger athletes (less than 35 years), SCD is often due to heart defects such as Hypertrophic obstructive cardiomyopathy, Anomalous left coronary artery from the pulmonary artery, Marfan syndrome and Brugada syndrome. A 12-lead ECG and/or 2D Echo should be considered in case of symptoms. If these reveal abnormal results, a more detailed work, including a cardiac MRI, exercise stress test, Holter monitoring and genetic testing is warranted.
In the event of cardiac arrest in an athlete, survival is improved by prompt recognition, the presence of trained medical personnel to initiate cardiopulmonary resuscitation (CPR), and early access to an automated external defibrillator. Creation of emergency response plans at sports and athletic venues may improve the outcome of SCD events in athletes. Senior consultant, Head of Cardio Thoracic surgery, BGS Gleneagles Global Hospital