Demographics and epidemiology of sudden deaths
in young competitive athletes: from the US national registry.
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.
among athletes most often occurred in African-American/Minorities and male
athletes. Hypertrophic cardiomyopathy was the most common cause of sudden cardiac
death.
Sudden
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%).
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%).
Overall,
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.
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 and
symptoms of hypertrophic cardiomyopathy? What types of screening methods do you
employ for pre-participation physical examination, if any?
you familiar with the signs and
symptoms of hypertrophic cardiomyopathy? What types of screening methods do you
employ for pre-participation physical examination, if any?
Written
by: Kyle Harris
by: Kyle Harris
Reviewed
by: Jeffrey Driban
by: Jeffrey Driban
Related
Posts:
Posts:
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
This is an area of research that i am very interested in because of the devastating aftermath of sudden death. Watching keenly. thanks for the post.
I think this is an interesting topic of conversation in the world of athletics. Sudden cardiac death can be preventable if the proper screening processes are taken. However, as we know that in some settings, the proper screening processes may not be available and if they are available may not be financially applicable. Seeing that minorities are at an increased risk of sudden cardiac death due to genetics or congenital is increasingly troubling due to the fact sometimes our most impoverished school systems have a high concentration of minorities who may not be able to be identified as at risk. I think this article shows that some measures need to be put into place to make screening processes for these heart conditions attainable if otherwise not. Heath care professionals should be advocates for their athletes and find out how at risks athletes can access these important screening tools. Insightful article.
Chris,
I certainly could not agree more with your comments. Clinicians do need to advocate for our patients/athletes. I would like to see data though on the presence of a sports medicine professional at these impoverished school systems you mentioned. Perhaps it's not the advocacy that is the issue as much as it is the access to a professional. If this is the case, maybe this a a prime opportunity to look into larger scale educational initiatives which may advocate for large groups without the presence of a dedicated sports medicine professional within that district.