Sudden cardiac death (SCD) in athletic activity is estimated to be between 1:50,000 and 1:100,000 young athletes per year. Potential causes for SCD include structural heart disease, inherited arrhythmia syndromes, and coronary heart disease. The most common structural heart diseases present in athletes less than 35 years of age are hypertrophic cardiomyopathy (HCM), arrhythmogenic right/left ventricular cardiomyopathy (ARVC), myocarditis, and congenital coronary artery anomalies.
HCM is relatively common disease, occurring in approximately 1 out of 500 individuals in the general population. In most athletes with SCD due to HCM, the diagnosis was not previously established.
Arrhythmogenic right ventricular dysplasia (ARVD), or also known as arrhythmogenic right ventricular cardiomyopathy (ARVC), is an important cause of sudden death among young athletes, accounting for approximately 11 percent of cases overall and 22 percent in athletes from one study. The overall prevalence in the general adult population is approximately 1 in 2000 to 1 in 5000. Presentation is most common between ages of 10 and 50 years, with a mean age of approximately 30 years. The principal symptoms of ARVC are dizziness, feeling of heart racing (palpitations) and loss of consciousness (syncope). However, as many as 40 percent of patients with ARVC are asymptomatic. In one study looking at patients with ARVC followed over 10 years, the mortality rate was 20 percent.
Genetic testing and other non-invasive testing such as an electrocardiogram (ECG), echocardiogram or possibly cardiac MRI, in conjunction with family history and referral to specialty center are often how the diagnoses is made. The best preventive measures are awareness and thorough physical and history by a certified examiner prior to sports participation.
Having access and knowledge on how to use an automated external defibrillator (AED) in case of SCD has been shown to significantly improve survival in out of hospital cardiac arrest. When applied in the setting of possible cardiac arrest, the newer AEDs inform rescuers whether a shock is indicated to allow lay rescuers to provide early defibrillation until additional public safety personnel can arrive.