Racial and Ethnic Disparities in Sudden Cardiac Arrest Among Competitive Athletes: a Review of the Sudden Cardiac Arrest Continuum

Purpose of Review In this review, we examine racial and ethnic sudden cardiac arrest (SCA) disparities in competitive athletes. We explore disparities across the continuum of care, including preparticipation cardiovascular screening, diagnostic evaluation, emergency response, and post-arrest management. Finally, we highlight opportunities to promote equitable and evidence-based prevention, evaluation, and treatment strategies in sports cardiology. Recent Findings SCA in young competitive athletes occurs disproportionately among Black athletes. Despite improvements in emergency preparedness, post-arrest survival remains disproportionately lower among Black and other non-White athletes. Available evidence does not support an inherited biologic explanation for these disparities. Inequities in structural and socioeconomic determinants of health, access to expert cardiovascular evaluations, emergency preparedness, as well as underrepresentation of minority athletes in registries and research cohorts may contribute to disparate SCA outcomes as a function of race and ethnicity and represent critical points of emphasis in future research efforts. Summary Racial and ethnic SCA disparities among athletes are best understood by appreciating race as a sociopolitical instead of biological construct and considering the entire continuum of care for competitive athletes. Mitigating disparities requires a shift in approach to individualized risk assessments, equitable access to cardiovascular care, comprehensive emergency preparedness, and diversification of research cohorts.