TY - JOUR
T1 - Etiology of sudden cardiac arrest and death in US competitive athletes
T2 - A 2-year prospective surveillance study
AU - Peterson, Danielle F.
AU - Siebert, David M.
AU - Kucera, Kristen L.
AU - Thomas, Leah Cox
AU - Maleszewski, Joseph J.
AU - Lopez-Anderson, Martha
AU - Suchsland, Monica Z.
AU - Harmon, Kimberly G.
AU - Drezner, Jonathan A.
N1 - Funding Information:
From the *University of Washington School of Medicine, Seattle, Washington; †Department of Family Medicine, Center for Sports Cardiology, University of Washington, Seattle, Washington; ‡Department of Exercise and Sport Science, National Center for Catastrophic Sports Injury Research, University of North Carolina, Chapel Hill, North Carolina; §Mayo Clinic, Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Rochester, Minnesota; and {Parent Heart Watch, Wilmington, Delaware. Supported by the National Center for Catastrophic Sports Injury Research (University of North Carolina at Chapel Hill), funded in part by the National Collegiate Athletic Association, the National Federation of State High School Associations, the American Football Coaches Association, and the American Medical Society for Sports Medicine. D. F. Peterson also received a grant from the University of Washington Medical Student Research Training Program for her work on the study. The authors report no conflicts of interest.
Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Objective:To determine the etiology of sudden cardiac arrest and death (SCA/D) in competitive athletes through a prospective national surveillance program.Design:Sudden cardiac arrest and death cases in middle school, high school, college, and professional athletes were identified from July 2014 to June 2016 through traditional and social media searches, reporting to the National Center for Catastrophic Sports Injury Research, communication with state and national high school associations, review of the Parent Heart Watch database, and search of student-athlete deaths on the NCAA Resolutions List. Autopsy reports and medical records were reviewed by a multidisciplinary panel to determine the underlying cause.Setting and Participants:US competitive athletes with SCA/D.Main Outcome Measures:Etiology of SCA/D.Results:A total of 179 cases of SCA/D were identified (74 arrests with survival, 105 deaths): average age 16.6 years (range 11-29), 149 (83.2%) men, 94 (52.5%) whites, and 54 (30.2%) African American. One hundred seventeen (65.4%) had an adjudicated diagnosis, including 83 deaths and 34 survivors. The most common etiologies included hypertrophic cardiomyopathy (19, 16.2%), coronary artery anomalies (16, 13.7%), idiopathic left ventricular hypertrophy/possible cardiomyopathy (13, 11.1%), autopsy-negative sudden unexplained death (8, 6.8%), Wolff-Parkinson-White (8, 6.8%), and long QT syndrome (7, 6.0%). Hypertrophic cardiomyopathy was more common in male basketball (23.3%), football (25%), and African American athletes (30.3%). An estimated 56.4% of cases would likely demonstrate abnormalities on an electrocardiogram.Conclusions:The etiology of SCA/D in competitive athletes involves a wide range of clinical disorders. More robust reporting mechanisms, standardized autopsy protocols, and accurate etiology data are needed to better inform prevention strategies.
AB - Objective:To determine the etiology of sudden cardiac arrest and death (SCA/D) in competitive athletes through a prospective national surveillance program.Design:Sudden cardiac arrest and death cases in middle school, high school, college, and professional athletes were identified from July 2014 to June 2016 through traditional and social media searches, reporting to the National Center for Catastrophic Sports Injury Research, communication with state and national high school associations, review of the Parent Heart Watch database, and search of student-athlete deaths on the NCAA Resolutions List. Autopsy reports and medical records were reviewed by a multidisciplinary panel to determine the underlying cause.Setting and Participants:US competitive athletes with SCA/D.Main Outcome Measures:Etiology of SCA/D.Results:A total of 179 cases of SCA/D were identified (74 arrests with survival, 105 deaths): average age 16.6 years (range 11-29), 149 (83.2%) men, 94 (52.5%) whites, and 54 (30.2%) African American. One hundred seventeen (65.4%) had an adjudicated diagnosis, including 83 deaths and 34 survivors. The most common etiologies included hypertrophic cardiomyopathy (19, 16.2%), coronary artery anomalies (16, 13.7%), idiopathic left ventricular hypertrophy/possible cardiomyopathy (13, 11.1%), autopsy-negative sudden unexplained death (8, 6.8%), Wolff-Parkinson-White (8, 6.8%), and long QT syndrome (7, 6.0%). Hypertrophic cardiomyopathy was more common in male basketball (23.3%), football (25%), and African American athletes (30.3%). An estimated 56.4% of cases would likely demonstrate abnormalities on an electrocardiogram.Conclusions:The etiology of SCA/D in competitive athletes involves a wide range of clinical disorders. More robust reporting mechanisms, standardized autopsy protocols, and accurate etiology data are needed to better inform prevention strategies.
KW - causes
KW - fatality
KW - pathologic
KW - prevention
KW - sports
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U2 - 10.1097/JSM.0000000000000598
DO - 10.1097/JSM.0000000000000598
M3 - Review article
C2 - 32639440
AN - SCOPUS:85088211381
SN - 1050-642X
VL - 30
SP - 305
EP - 314
JO - Clinical Journal of Sport Medicine
JF - Clinical Journal of Sport Medicine
IS - 4
ER -