Key result
Exertional collapse associated with sickle trait presents as a conscious collapse without neurological changes, occurring early in workouts with mild temperature elevation and muscle pain.
Why the study?
Exertional collapse associated with sickle cell trait is an underrecognized cause of exertional collapse, prompting discussion on early recognition, emergency management, and prevention in athletes.
Case Report (n=15)
Exertional collapse associated with sickle trait has a distinct clinical presentation that requires early recognition and aggressive management to prevent end-organ failure.
May aid early recognition of exertional collapse in sickle trait; leaves open prospective validation before practice change.
Exertional collapse associated with sickle trait (ECAST) is an underrecognized cause of exertional collapse triggered by complex mechanisms involving acidosis, rhabdomyolysis, and arrhythmias, all of which create sickling, vaso-occlusive problems, and ultimately end organ failure. Three cases are described in young athletes, as well as 12 other examples of ECAST noted in case reports and news sources. Exertional collapse associated with sickle trait can be differentiated from other common causes of collapse (exertional heat syndrome, acute cardiac events, and asthma) because it is a conscious collapse without neurological changes, occurs early in workout with only mildly elevated body temperature, and involves muscle pain and weakness but not cramping. Aggressive early management and transport to care facilities can reverse ECAST in certain cases. This article discusses tips for early recognition, initial treatment in the emergency department, and precautions that can be taken to prevent sickling collapse in athletes with sickle cell trait (SCT).
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Newman et al. (2019) conducted a case report in Exertional collapse associated with sickle trait (ECAST) (n=15). Sickle cell trait vs. Other common causes of collapse (exertional heat syndrome, acute cardiac events, asthma) was evaluated on Clinical presentation and differentiation from other causes of collapse. Exertional collapse associated with sickle trait presents as a conscious collapse without neurological changes, occurring early in workouts with mild temperature elevation and muscle pain.
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