Key result
Congenital abnormalities drive SCD in young athletes while coronary atherosclerosis dominates in older athletes.
Sudden cardiac death in athletes is primarily caused by congenital abnormalities in the young and coronary atherosclerosis in older individuals, and routine screening is likely not cost-effective.
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May support targeted evaluation in symptomatic athletes; leaves open cost-effectiveness of routine screening.
Sudden death in athletes is a rare but tragic occurrence. Congenital cardiovascular abnormalities, usually asymptomatic and often undiagnosed during life, are the main causes in young athletes. Hypertrophic cardiomyopathy and congenital coronary anomalies are the most commonly occurring disorders. Idiopathic concentric left ventricular hypertrophy (non-physiological), arrhythmogenic right ventricular dysplasia and Marfan's syndrome with aortic rupture have also been implicated. Rarer causes include mitral valve prolapse and myocarditis. Coronary atherosclerosis is the major cause in older, and occasionally in younger athletes. Those involved in the medical care of athletes should be aware of the potential causes of sudden death in these groups. Symptomatic athletes should be fully investigated. Screening programmes are probably not justified on a cost effective basis.
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Kenny et al. (1992) conducted a review in Sudden cardiac death in athletes. Congenital cardiovascular abnormalities are the main causes of sudden cardiac death in young athletes, while coronary atherosclerosis is the major cause in older athletes.
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