Can we prevent sudden cardiac deaths in athletes?

In the middle of a soccer match, a young athlete collapses on the pitch, right in front of his horrified parents and friends. It is already too late: the athlete has suddenly expired from a cardiac disease that had remained undetected by all until this tragic day.

Although this phenomenon is quite rare and touches one or two athletes out of 200,000 each year, sudden death in athletes always stuns the entire community. Most deaths are attributed to cardiac anomalies or familial hypercholesterolemia. Can we prevent them? It would seem so. A program implemented in Italy in 1982 may have helped decrease the number of Sudden Cardiac Deaths (SCDs) in young athletes.

Since 1982, Italy requires that all athletes participating in competitions undergo a medical examination including a physical, an evaluation of the athlete’s family history of heart disease (screening for cardiomyopathies) as well as an electrocardiogram (ECG). Hence, since 1979, the number of SCDs in Italian athletes between the ages of 12 to 35 has plummeted by 89%, while the number of SCDs in non-athletes has remained stable.

It would seem that most of the people who succumbed to SCDs had ignored warning symptoms before that fateful day. Take heed! An athlete who experiences serious stomach or chest pains should suspend all intense physical exercise immediately and see a physician as early as possible.

Canada does not seem to want to follow the Italian lead. Aside from costs, it is feared that athletes who are “excluded” will completely abandon all physical activities and increase their risks of suffering from heart disease later in life. In fact, the Italian program has prevented about 2% of all athletes from participating in competitive sports. Should we aim to prevent a few deaths on the field during adolescence, only to instigate many in the forties and fifties due to inactivity and cardiovascular diseases? Considering that North America faces a shortened life expectancy in its population because of the incessantly escalating obesity epidemic, this poses quite a conundrum.

Nevertheless, it is fundamental to understand that a person over the age of 50 who has been sedentary for many years must meet with a physician before starting any exercise program. In addition, a younger person who has a family history of cardiovascular disease or SCD should also undergo screening to detect any cardiac anomalies before starting a serious physical training program.

You only have one heart and one body, make sure you take good care of them!