Sudden Death during Sports Activities

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Sudden Death during Sports Activities

Journal Title: Biology of Exercise - Year 2016, Vol 12, Issue 1

Abstract

Sudden death during sports activities is a relatively rare, yet tragic event, with significant economic and social consequences. According to the existing studies, the annual incidence ranges from 3/100,000 to 1/250,000. The victims are mainly males with ratios varying from 18/1 to 9/1. The colored athletes are proportionally more susceptible and have a particular sensitivity to hypertrophic cardiomyopathy. Athletes have a 2.8/1 higher risk to have sudden death than non-athletes. But this is usually due to the undetected underlying cardiovascular disease. The main cause of sudden cardiac death in individuals older than 35 years by far is the coronary heart disease. With regard to people less than 35 years old, opinions differ, with studies on the U.S. having the first cause the hypertrophic cardiomyopathy, while studies in Italy, the arrhythmogenic right ventricular heart disease. Other common causes of sudden death during exercise are congenital anomalies of the coronary arteries, Commotio Cordis, myocarditis, diastolic cardiomyopathy, prolapse of the mitral valve, aortic stenosis, aortic rupture, etc. Regarding the non-cardiac sudden deaths, blunt trauma is the most frequent cause, and the parts of the body that are more frequently battered are the head and neck. Other, less common causes are stroke, the use of illicit drugs and pulmonary diseases. The sports in which most frequently occur sudden deaths are football, basketball, running, cycling and swimming. The death rate in each sport is due to the combination of the cardiovascular requirement and the total number of people involved with it. Screening of athletes for their participation in the athletic procedure saves lives and everyone agrees that it is necessary. But there is a serious disagreement between the U.S. and Europe, whether the screening procedure should include the electrocardiograms. The main reason cited by the U.S. for the non-use of the ECG is the high cost it requires. Chronic exercise induces the remodeling of the heart in order to respond to the cardiovascular demands. This phenomenon is called â€œthe athleteâ€™s heartâ€. This depends on the intensity and type of the exercise. In endurance athletes, it causes mainly the increasing of the internal diameter of the left ventricle and in power athletes, the increasing of the wall thickness of the left ventricle. There is often confusion between the Â«athleteâ€™sÂ» and the abnormal heart since in mild forms of the disease, some features such as the thickness of the wall of the left ventricle, can have similar sizes. The mechanisms leading to these sudden deaths are either of mechanical nature or electrical with the latter constituting for over 90% of the cases.

Authors and Affiliations

STERGIOULAS APOSTOLOS| Professor, Faculty of Human Movement & Quality of Life, Peloponnese University, Sparta, Laconia, Greece, ANASTASIOS G. PRIFTAKIS| Ph.D. Candidates. Faculty of Human Movement & Quality of Life, Peloponnese University, Sparta, Laconia, Greece, NIKOLAOS VASILAKIS| Ph.D. Candidates. Faculty of Human Movement & Quality of Life, Peloponnese University, Sparta, Laconia, Greece

Keywords

EP ID EP15881
DOI http: doi.org/10.4127/jbe.2016.0102
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