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Sudden Death in Athletes

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Sudden Death in Athletes

  • Epidemiology
  1. Less common than death from other medical conditions
    1. High School and College Athletes
      1. Sudden death Incidence: 1 in 200,000
    2. Adult Athletes
      1. Sudden death Incidence: 1 in 50,000
  2. Conditions predisposing to sudden death
    1. Incidence: 1 in 20,000 athletes
  3. Sudden death is 5 fold higher in young men than women
  4. Sudden death risk is increased with Sickle Cell Trait
    1. Relative Risk: 27 times risk of african american males
    2. Relative Risk: 40 times risk of caucasian males
  • Evaluation
  • Screening
  1. See Pre-participation History for cardiac red flags
  • Causes
  • Evaluation
  • Guidelines (26th Bethesda conference)
  1. Preparticipation Physical
    1. Careful History and Physical every 2 years
    2. No Regular Chest XRay, Electrocardiogram, or Labs
  2. Sinus Arrhythmia
    1. Arrhythmias
      1. Asymptomatic Sinus Bradycardia
      2. Asymptomatic Sinus arrhythmia
      3. Asymptomatic Sinus pause
    2. Episodes lasting less than 3 seconds and asymptomatic
      1. No further evaluation needed
    3. Symptomatic episodes
      1. Electrocardiogram
      2. Holter Monitor or Event Monitor
      3. Echocardiogram
      4. Exercise Stress Testing
  3. First Degree Atrioventricular Block
    1. Asymptomatic
      1. Electrocardiogram only
    2. Symptomatic or PR interval exceeds 0.3 seconds
      1. Holter Monitor or Event Monitor
      2. Echocardiogram
      3. Exercise Stress Testing
  4. Mobitz II Second Degree Atrioventricular Block
    1. Electrocardiogram
    2. Holter Monitor or Event Monitor
    3. Echocardiogram
    4. Exercise Stress Testing
  5. Atrial Fibrillation
    1. Electrocardiogram
    2. Holter Monitor or Event Monitor
    3. Echocardiogram