Demographics and epidemiology of sudden deaths
in young competitive athletes: from the US national registry.

Maron BJ, Haas TS, Ahluwalia A, Murphy CJ, and Garberich RF. Am J Med. 2016. [Epub Ahead of Print].

Take Home Message: Sudden cardiac death
among athletes most often occurred in African-American/Minorities and male
athletes. Hypertrophic cardiomyopathy was the most common cause of sudden cardiac

death in sports devastates communities and has garnered much media attention. Understanding
the factors associated with sudden deaths could help clinicians develop
screening criteria to identify potential cases early. Therefore, Maron and
colleagues studied how race and sex influences sudden death among young
athletes and their underlying causes. Researchers accessed the
US National Registry of Sudden Death in Athletes (1980 to 2011) to gather pertinent
information. Deceased athletes were included if they experienced sudden death
and engaged in an organized sport. Deaths in club sports, intramural sports, or
other causes (automobile accidents, cancer, etc.) were excluded. The
researchers calculated incidence rates with public data about the number of
athletes participating each year in organized high school and collegiate
sports. A total of 2,406 athlete deaths were identified, 214 of which had no
recorded cause of death. Of the remaining 2,192 athlete deaths, 842 (38%)
deaths were confirmed to have genetic or congenital cardiovascular disease. Males
athletes were 89% of all recorded athlete deaths. Male athletes were 8 times
more likely to develop sudden death than female athletes. African-American/Minorities
were 3.2 times more likely to suffer sudden death than whites. The single most
common cause of sudden cardiac death was hypertrophic cardiomyopathy (302, 36%),
which was more common among African-American/Minority males (53% of all cases)
and white males (44%).

the data supports prior evidence that African-American/Minority males were most
likely to experience sudden cardiac death. This, coupled with the finding that
the most common cause of death was hypertrophic cardiomyopathy, suggests that
screening methods should focus on these factors. The sports medicine community
has hotly debated whether athletes should be screened for risk factors of
sudden cardiac death. There’s often concerns about the costs of screening,
psychosocial issues related to false positive exams, and our moral obligation
to deploy available screening methods to save lives. The researchers suggested
that these results highlight the potential value of preparticipation screening
in minority communities. While screening all African-American/Minority communities
may not be practical, the data presented should signal that more effective and
efficient screening methods should be developed. Until such time that a more
effective and efficient screening protocol is identified clinicians can still
use the data presented to influence clinical practice by being aware of the
common signs and symptoms of hypertrophic cardiomyopathy and sudden death (see
below). This will allow clinicians to recognize and intervene as quickly as
possible, hopefully preventing sudden cardiac death. Furthermore, there is a
need for sports medicine clinicians to educate high-risk athletes about their
risk so that the athlete and their family can make an informed decision about
whether to privately seek screening or participate in sports.

Questions for Discussion: Are
you familiar with the signs
symptoms of hypertrophic cardiomyopathy? What types of screening methods do you
employ for pre-participation physical examination, if any?

by: Kyle Harris
by:  Jeffrey Driban


Maron BJ, Haas TS, Ahluwalia A, Murphy CJ, & Garberich RF (2016). Demographics and Epidemiology of Sudden Deaths in Young Competitive Athletes: From the U.S. National Registry. The American Journal of Medicine PMID: 27039955