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Robles AG, Palamà Z, Nesti M, Tunzi RM, Delise P, Cavarretta E, Penco M, Romano S, Sciarra L. Sport Related Sudden Death: The Importance of Primary and Secondary Prevention. J Clin Med 2022; 11:jcm11164683. [PMID: 36012921 PMCID: PMC9410008 DOI: 10.3390/jcm11164683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/20/2022] [Accepted: 08/01/2022] [Indexed: 12/02/2022] Open
Abstract
Sports are a double-edged sword. On the one hand, cardiovascular benefits from sports activity are well-known, and on the other hand, sports may increase the risk of sudden cardiac death (SCD) in subjects with known or unknown cardiovascular diseases. SCD is rare but has a very strong emotional issue. There are many examples involving famous professional athletes, but this is only scratching the surface of a widespread phenomenon that also involves amateur athletes. The importance of safely performing physical activity appears clear in both professional and amateur athletes. In particular, the former undergo a pre-participation screening for SCD primary prevention with different recommendations in each country. On the other hand, a medical examination is not mandatory for non-professional athletes and, therefore, for people who practice sports as an amateur. Widespread distribution of automatic external defibrillators and people trained for cardiopulmonary resuscitation are necessary to promote secondary prevention of SCD. We briefly report a case series of athletes with aborted SCD during sports activity in order to underline and discuss in this review the previously highlighted issues.
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Affiliation(s)
- Antonio Gianluca Robles
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Zefferino Palamà
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Martina Nesti
- Cardiovascular and Neurological Department, Ospedale San Donato, 52100 Arezzo, Italy
| | | | - Pietro Delise
- Division of Cardiology, Hospital ‘P. Pederzoli’, 37019 Peschiera del Garda, Italy
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy
- Mediterranea Cardiocentro, 80122 Naples, Italy
| | - Maria Penco
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Silvio Romano
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
- Correspondence: ; Tel.: +39-0862434740; Fax: +39-0862433425
| | - Luigi Sciarra
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
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Solberg EE, Borjesson M, Sharma S, Papadakis M, Wilhelm M, Drezner JA, Harmon KG, Alonso JM, Heidbuchel H, Dugmore D, Panhuyzen-Goedkoop NM, Mellwig KP, Carre F, Rasmusen H, Niebauer J, Behr ER, Thiene G, Sheppard MN, Basso C, Corrado D. Sudden cardiac arrest in sports – need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Prev Cardiol 2015; 23:657-67. [DOI: 10.1177/2047487315599891] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 07/21/2015] [Indexed: 12/16/2022]
Affiliation(s)
- EE Solberg
- Diakonhjemmet Hospital, Department of Medicine, Oslo, Norway
| | - M Borjesson
- Swedish School of Sport and Health Sciences, Stockholm, Sweden; Karolinska University Hospital
| | - S Sharma
- St George’s University of London, UK
| | | | - M Wilhelm
- University Clinic for Cardiology, Cardiovascular Prevention, Rehabilitation & Sports Medicine, Inselspital, Bern, Switzerland
| | - JA Drezner
- Department of Family Medicine, University of Washington, Seattle, USA
| | - KG Harmon
- Department of Family Medicine, University of Washington, Seattle, USA
| | - JM Alonso
- Aspetar, Qatar Orthopedics and Sports Medicine Hospital, Sports Medicine Department, Doha, Qatar
| | - H Heidbuchel
- Cardiology – Arrhythmology, University Hospital Leuven, Belgium
| | - D Dugmore
- Department of Sports medicine, Perform Sports medicine centre, Burton upon Trent, UK
| | - NM Panhuyzen-Goedkoop
- Radboud University Nijmegen MC, The Netherlands; Sports Medical Centre Papendal Arnhem, The Netherlands
| | - K-P Mellwig
- Department of Cardiology, Heart and Diabetes Centre NRW, Ruhr University of Bochum, Bad Oeynhausen, Germany
| | - F Carre
- Pontchaillou Hospital, Rennes, France; INSERM U1099, Rennes, France
| | - H Rasmusen
- Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - J Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - ER Behr
- St George’s University of London, UK
| | - G Thiene
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
| | | | - C Basso
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
| | - D Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy
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Cox AT, Boos CJ, Sharma S. The Hearts of Heroes: the epidemiology of cardiac disease in the UK Armed Forces. J ROY ARMY MED CORPS 2015; 161:169-72. [DOI: 10.1136/jramc-2015-000498] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 06/27/2015] [Indexed: 01/16/2023]
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Abstract
Physical activity is a potent therapy for both the prevention and treatment of cardiovascular disease. Exercise appears to most benefit people who are the least active. There is some evidence to suggest that a curvilinear relationship exists between exercise and survival, whereby beyond an optimal level of fitness, the principle of diminishing returns applies. Indeed, some go further in suggesting that there is evidence that extreme athletic training may be harmful in some individuals. The incidence of sudden cardiac death in athletes is greater than in matched, nonathletic counterparts, and this finding is driven by the provocation of an underlying cardiac abnormality by strenuous exertion. The task of detecting pathological myocardial substrate in athletes is made difficult by physiological adaptations to exercise that can mimic the appearance of cardiomyopathies and ion channelopathies in some individuals. This article details the clinical evaluation of the athlete with reference limits for cardiac physiological remodeling and discusses the diagnostic dilemmas that arise.
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Affiliation(s)
- Andrew D'Silva
- Department of Cardiovascular Sciences, St. George's University of London, London, UK
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Abstract
The increasing globalization of sport has resulted in athletes from a wide range of ethnicities emerging onto the world stage. Fuelled by the untimely death of a number of young professional athletes, data generated from the parallel increase in preparticipation cardiovascular evaluation has indicated that ethnicity has a substantial influence on cardiac adaptation to exercise. From this perspective, the group most intensively studied comprises athletes of African or Afro-Caribbean ethnicity (black athletes), an ever-increasing number of whom are competing at the highest levels of sport and who often exhibit profound electrical and structural cardiac changes in response to exercise. Data on other ethnic cohorts are emerging, but remain incomplete. This Review describes our current knowledge on the impact of ethnicity on cardiac adaptation to exercise, starting with white athletes in whom the physiological electrical and structural changes--collectively termed the 'athlete's heart'--were first described. Discussion of the differences in the cardiac changes between ethnicities, with a focus on black athletes, and of the challenges that these variations can produce for the evaluating physician is also provided. The impact of ethnically mediated changes on preparticipation cardiovascular evaluation is highlighted, particularly with respect to false positive results, and potential genetic mechanisms underlying racial differences in cardiac adaptation to exercise are described.
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Affiliation(s)
- Nabeel Sheikh
- Division of Clinical Sciences, St George's University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Sanjay Sharma
- Division of Clinical Sciences, St George's University of London, Cranmer Terrace, London SW17 0RE, UK
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Jackson G. Evaluating the athlete's heart - now and in the future. Int J Clin Pract 2012; 66:725. [PMID: 22805262 DOI: 10.1111/j.1742-1241.2012.02995.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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