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Evans L, Hutt K. Sudden Cardiac Death in Dancers and Athletes: Time for Increased Cardiac Screening? J Dance Med Sci 2024; 28:132-138. [PMID: 37864364 DOI: 10.1177/1089313x231203052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
Background: Young athletes are thought to be models of peak physical condition, capable of exceptional physical accomplishments. However approximately 64 UK athletes aged 12 to 35 will die each year from a phenomenon known as Sudden Cardiac Death (SCD). SCD can be defined as an unexpected death as a result of abrupt loss of cardiac function within an hour of symptom onset. Undiagnosed heart conditions such as arrhythmias are often found to be the cause of SCD. Advantageous physical attributes found in athletes' hearts can complicate diagnoses as hearts with inherited conditions can appear physiologically similar to hearts adapted to strenuous exercise. Growing research surrounding SCD within sporting populations aims to decrease mortality rates however there is an absence of study specifically into SCD in dance. Within sport, the topic of cardiac screening has generated widespread controversy which is fueled by a lack of empirical evidence. There is currently no international consensus of pre participation cardiac screening methods within dance or sport, potentially leaving many dancers and athletes at risk. Methods: As part of this study, existing material surrounding the topics of SCD and cardiac screening in athletes and dancers was gathered. All existing studies at the time of writing in relation to cardiac screening in athletes and dancers were collected and analysed in order to compare results and evaluate the methodological limitations.This process aimed to identify gaps in current knowledge and research to inform future study. Results: This article aimed to analyze the epidemiology of SCD within sport and dance and to make recommendations for pre-participation screening within dance institutions. The study highlights the need to increase awareness of SCD within the dance community and determine appropriate screening approaches depending on context and setting.
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Affiliation(s)
- Lola Evans
- London Contemporary Dance School, London, UK
| | - Kim Hutt
- London Studio Centre, London, UK
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Stormholt ER, Svane J, Lynge TH, Tfelt-Hansen J. Symptoms Preceding Sports-Related Sudden Cardiac Death in Persons Aged 1-49 Years. Curr Cardiol Rep 2021; 23:8. [PMID: 33409809 DOI: 10.1007/s11886-020-01438-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Sports-related sudden cardiac death (Sr-SCD) is a leading natural cause of death in young athletes. To prevent Sr-SCD in athletes, it is important to identify individuals at risk. This review sought to summarize the current knowledge of symptoms prior to Sr-SCD in athletes aged 1-49 years. RECENT FINDINGS Cardiovascular screening of athletes is a subject of interest. However, the cost of ECG screening in a young population is relatively high compared to potential benefits, and systematic screening of athletes is heavily debated. In the background population, both cardiac and non-specific symptoms are often present prior to SCD. Both cardiac and non-specific symptoms are present in up to 74% prior to Sr-SCD. The main symptoms are syncope, chest pain, palpitations and dizziness. Knowledge of symptoms could potentially be used in combination with non-invasive prediction models to prevent Sr-SCD and treat athletes at risk.
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Affiliation(s)
- Emma Ritsmer Stormholt
- The Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Section 2142, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
| | - Jesper Svane
- The Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Section 2142, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
- Section of Forensic Pathology, Department of Forensic Medicine, Copenhagen University, Copenhagen, Denmark
| | - Thomas Hadberg Lynge
- The Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Section 2142, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
| | - Jacob Tfelt-Hansen
- The Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Section 2142, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
- Section of Forensic Pathology, Department of Forensic Medicine, Copenhagen University, Copenhagen, Denmark
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Sweeting J, Semsarian C. Sudden Cardiac Death in Athletes. Heart Lung Circ 2018; 27:1072-1077. [PMID: 29705387 DOI: 10.1016/j.hlc.2018.03.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/21/2018] [Indexed: 11/25/2022]
Abstract
Sudden cardiac death (SCD) in athletes is a rare but tragic complication of a number of cardiovascular diseases. Inherited causes such as the structural and arrhythmogenic genetic heart conditions are often found or suspected to be the underlying cause of death at post mortem examination. Physical activity and intense exercise may trigger cardiac arrhythmias in individuals with these conditions leading to SCD. Prevention and treatment strategies include individual athlete management strategies, coupled with public health measures such as universal cardiopulmonary resuscitation (CPR) training and availability of automatic external defibrillators (AEDs) in public places, thereby preventing SCD in both athletes and the general population. Where an athlete is known to have a cardiac condition, some restrictions from participation may be prudent, however, new evidence is emerging that perhaps current restrictions are too strict and could be relaxed in some cases. An athlete-centred model of care is essential to ensure the clinical implications and athlete preferences are balanced providing the best outcome for all concerned.
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Affiliation(s)
- Joanna Sweeting
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
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Affiliation(s)
- Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Newtown, NSW, 2042, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Joanna Sweeting
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Newtown, NSW, 2042, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Michael J Ackerman
- Departments of Medicine, Pediatrics, and Molecular Pharmacologyand Experimental Therapeutics, Divisions of Cardiovascular Diseases and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, USA
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Najari F, Alimohammadi A, Ghodrati P. Sudden Death Following Exercise; a Case Series. EMERGENCY (TEHRAN, IRAN) 2016; 4:97-100. [PMID: 27274521 PMCID: PMC4893759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Natural and unexpected death that happens within less than one hour of first symptom occurrence is called sudden death. Cardiovascular diseases are the main known reason of sudden death and more than 75% of sudden deaths in athletes are assigned to it. Here we reported the autopsy results of all cases with sudden death following exercise that were referred to forensic center of Tehran, Iran, from 2009 to 2014. METHODS In this cross sectional study all subjects who were registered to forensic medicine center of Tehran, Iran, from 2009 to 2014, as a case of sudden death following exercise were evaluated. Demographic data and medical history as well as autopsy and toxicology findings were retrospectively gathered using profiles of the deceased. Results were reported using descriptive analysis. RESULTS 14 cases were registered as sudden death following exercise in forensic medicine profiles during the study period. Exploring the files of the mentioned deceased, revealed five non-compatible cases in this regard. Finally, 9 eligible cases were enrolled (88.9% male). The mean age of the deceased was 28.66 ± 10.86 years (range: 7 - 40). Toxicological tests were available for 7 cases, one of which was positive for tramadol. Sudden death following football was reported most frequently (44.4%). Only 3 (33.3%) cases had herald signs such as chest pain, syncope, or loss of consciousness. 1 case (11.11%) had a positive history of sudden death in relatives. CONCLUSION Although most sudden death victims are asymptomatic until the event, all those who suffer from symptoms such as chest pain, shortness of breath, dizziness, fatigue and irregular heart rate during physical activities, should be screened regarding common probable causes of sudden death.
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Affiliation(s)
- Fares Najari
- Faculty Member of Shahid Beheshti University of Medical Science, Tehran, Iran.,Corresponding Author: Fares Najari; Department of forensic Medicine, Shohadaye Tajrish Hospital, Tajrish Square, Tehran, Iran. Tal: 00989123195140,
| | | | - Parisa Ghodrati
- Forensic Medicine Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ozbilgin S, Kuvaki B, Hanci V, Ungur G, Tutuncu O, Koca M, Akin S, Certug A. Awareness and attitudes to cardiopulmonary resuscitation among football players: A survey in Turkey. Resuscitation 2015. [DOI: 10.1016/j.resuscitation.2015.09.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Farioli A, Christophi CA, Quarta CC, Kales SN. Incidence of sudden cardiac death in a young active population. J Am Heart Assoc 2015; 4:e001818. [PMID: 26066031 PMCID: PMC4599531 DOI: 10.1161/jaha.115.001818] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 04/20/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Little is known about the burden of sudden cardiac death (SCD) among active, presumably healthy persons. We investigated the incidence of SCD among US male career firefighters. METHODS AND RESULTS All on-duty SCDs among US male career firefighters between 1998 and 2012 were identified from the US Fire Administration and the US National Institute for Occupational Safety and Health databases. Age-specific incidence rates (IRs) of SCD with 95% CIs were computed. A joinpoint model was fitted to analyze the trend in IR and to help estimate the annual percentage change of SCD rates over the years. The effects of seasonality were assessed through a Poisson regression model. We identified 182 SCDs; based on 99 available autopsy reports, the leading underlying cause of death was coronary heart disease (79%). The overall IR was 18.1 SCDs per 100 000 person-years. The age-specific IRs of SCD ranged between 3.8 (for those aged 18 to 24 years) and 45.2 (for those aged 55 to 64 years) per 100 000 person-years. The annual rate of SCD steadily declined over time (annual percentage change -3.9%, 95% CI -5.8 to -2.0). SCD events were more frequent during January (peak-to-low ratio 1.70; 95% CI 1.09 to 2.65). In addition, the IR was 3 times higher during high-risk duties compared with low-risk duties. IRs among firefighters were lower than those observed among the US general population and US military personnel. CONCLUSIONS SCD risk in this active working population is overestimated using statistics from the general population. To address public health questions among these subpopulations, more specific studies of active adults should be conducted.
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Affiliation(s)
- Andrea Farioli
- Department of Environmental Health (Environmental & Occupational Medicine & Epidemiology), Harvard TH Chan School of Public HealthBoston, MA (A.F., C.A.C., S.N.K.)
- The Cambridge Health Alliance, Harvard Medical SchoolCambridge, MA (A.F., S.N.K.)
- Department of Medical and Surgical Sciences (DIMEC), University of BolognaItaly (A.F.)
| | - Costas A Christophi
- Department of Environmental Health (Environmental & Occupational Medicine & Epidemiology), Harvard TH Chan School of Public HealthBoston, MA (A.F., C.A.C., S.N.K.)
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of TechnologyLimassol, Cyprus (C.A.C.)
| | - Candida Cristina Quarta
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical SchoolBoston, MA (C.C.Q.)
- Institute of Cardiology, University of Bologna and S.Orsola-Malpighi HospitalBologna, Italy (C.C.Q.)
| | - Stefanos N Kales
- Department of Environmental Health (Environmental & Occupational Medicine & Epidemiology), Harvard TH Chan School of Public HealthBoston, MA (A.F., C.A.C., S.N.K.)
- The Cambridge Health Alliance, Harvard Medical SchoolCambridge, MA (A.F., S.N.K.)
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Beutler J, Schmid E, Fischer S, Hürlimann S, Konrad C. [Sudden cardiac death during a city marathon run]. Anaesthesist 2015; 64:451-5. [PMID: 26031561 DOI: 10.1007/s00101-015-0043-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 04/25/2015] [Accepted: 04/28/2015] [Indexed: 12/29/2022]
Abstract
Sudden cardiac death (SCD) in young athletes during physical stress is a rare event with an incidence of 1-3 deaths per 100,000 athletes per year. A coronary anomaly is the second most common cause of death following hypertrophic cardiomyopathy. Symptomatic prodromes occur in 20% of cases prior to the SCD event. This case report describes a 35-year-old male who collapsed near the finishing line of a half marathon run. Despite immediate resuscitation attempts and initial return of spontaneous circulation (ROSC), a pulseless electrical activity (PEA) followed and the patient died 1 h after arrival in the resuscitation unit. The autopsy revealed an anomalous left coronary artery (ALCA), which can lead to ischemia of the respective heart muscles under severe stress.
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Affiliation(s)
- J Beutler
- Klinik für Anästhesie, Chirurgische Intensivmedizin, Rettungsmedizin und Schmerztherapie, Luzerner Kantonsspital, 6000, Luzern 16, Schweiz,
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Student athletes, sudden cardiac death, and lifesaving legislation: a review of the literature. J Pediatr Health Care 2015; 29:233-42. [PMID: 25577720 DOI: 10.1016/j.pedhc.2014.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 11/10/2014] [Accepted: 11/11/2014] [Indexed: 11/23/2022]
Abstract
PURPOSE The purpose of this article is to present findings of a literature review examining the use of automatic external defibrillators (AEDs) for student athletes experiencing sudden cardiac arrest and variances in state legislation regarding the mandatory placement of AEDs in school gymnasiums and athletic fields. METHODS A broad search of computerized databases was conducted utilizing PubMed, Medline, CINHAHL, and the Cochrane Databases, which provided a broad but not exhaustive review of the current literature related to student athletes, sudden cardiac death, and the use of AEDs. The articles were evaluated and graded using Stetler's strength of evidence guidelines. FINDINGS A total of 17 articles are included in this literature review (Stetler's Grade I, n = 1; Grade II, n = 2; Grade III, n =2; Grade IV, n = 5; Grade V, n = 3; and Grade VI, n = 4). The literature produced few meta-analyses of controlled studies, experimental studies, and quasi-experimental studies on the topic of student athletes at risk for sudden cardiac death. The majority of the literature is based on expert opinion, case reports, and retrospective data sets. The literature does support the correlation of early cardiopulmonary resuscitation and defibrillation with increased survival rates among persons experiencing sudden cardiac arrest. CONCLUSIONS Additional evidence-based research is needed to support the long-term outcomes of AED legislation and its utility in sparing the lives of student athletes. However, the evidence supporting early intervention, a coordinated emergency plan, and rapid emergency medical services response is conclusive enough to warrant state or federal legislation mandating that AEDs be present in all school gyms and athletic fields.
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Abstract
High performance sports medicine involves the medical care of athletes, who are extraordinary individuals and who are exposed to intensive physical and psychological stresses during training and competition. The physician has a broad remit and acts as a 'medical guardian' to optimise health while minimising risks. This review describes this interesting field of medicine, its unique challenges and priorities for the physician in delivering best healthcare.
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Affiliation(s)
- Cathy Speed
- Cambridge Centre for Health and Performance, Impington, Cambridge.
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