Harms and benefits of screening young people to prevent sudden cardiac death

Brabandt, Hans Van; Desomer, Anja; Gerkens, Sophie; Neyt, Mattias

doi:10.1136/bmj.i1156

Cited by 52 publications

(59 citation statements)

References 41 publications

(60 reference statements)

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“…We do not advocate mandatory PPS at this stage [27]. Although the addition of cardiac CT to the sports medical examination does not have a major psychological impact in older sportsmen, a randomised study is needed to investigate whether the introduction of a sports medical examination (including CT scanning) reduces the incidence of (exercise-related) cardiac events in older athletes and is cost-effective.…”

Section: Discussionmentioning

confidence: 99%

No psychological distress in sportsmen aged 45 years and older after cardiovascular screening, including cardiac CT: The Measuring Athlete’s Risk of Cardiovascular events (MARC) study

et al. 2017

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BackgroundPsychological distress caused by cardiovascular pre-participation screening (PPS) may be a reason not to implement a PPS program. We assessed the psychological impact of PPS, including cardiac computed tomography (CT), in 318 asymptomatic sportsmen aged ≥45 years.MethodsCoronary artery disease (CAD) was defined as a coronary artery calcium score ≥100 Agatson units and/or ≥50% luminal stenosis on contrast-enhanced cardiac CT. Psychological impact was measured with the Impact of Event Scale (IES) (seven items) on a six-point scale (grade 0–5). A sum score ≥19 indicates clinically relevant psychological distress. A Likert scale was used to assess overall experiences and impact on sports and lifestyle.ResultsA total of 275 participants (86.5% response rate, 95% CI 83–90%) with a mean age of 54.5 ± 6.4 years completed the questionnaires, 48 (17.5%, 95% CI 13–22%) of whom had CAD. The median IES score was 1 (IQR 0–2, [0–23]). IES was slightly higher in those with CAD (mean rank 175 vs. 130, p < 0.001). One participant (with CAD) experienced clinically relevant psychological distress (IES = 23). Participants reported numerous benefits, including feeling safer exercising (58.6%, 95% CI 53–65%) and positive lifestyle changes, especially in those with CAD (17.2 vs. 52.1%, p < 0.001). The majority were satisfied with their participation (93.8%, 95% CI 91–97%).ConclusionCardiovascular PPS, including cardiac CT, causes no relevant psychological distress in older sportsmen. Psychological distress should not be a reason to forego screening in sportsmen.Electronic supplementary materialThe online version of this article (doi: 10.1007/s12471-017-0948-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

No psychological distress in sportsmen aged 45 years and older after cardiovascular screening, including cardiac CT: The Measuring Athlete’s Risk of Cardiovascular events (MARC) study

et al. 2017

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“…In der Literatur finden sich zahlreiche Hinweise auf Unterschiede innerhalb Europas bei medizinischen Untersuchungen vor sportlichen Aktivitäten. In Italien gibt es solche Untersuchungen seit 1970, in den Niederlanden seit 1984 [2,10]. Beispielsweise konnte dadurch seit 1982 in der Region Veneto/Italien die Inzidenz des plötzlichen Herztods bei 12-35-jährigen Sportlern von 4 auf 0,4 pro 10 000 Personenjahren gesenkt werden.…”

Section: Diskussionunclassified

Plötzlicher Herztod bei 17-jährigem Mädchen – ein Fallbericht

Huscher

Trägner

Jacobi

et al. 2018

Notarzt

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Zusammenfassung Falldarstellung Eine 17-jährige Gymnasiastin betätigte sich in einer Freizeitsportgruppe körperlich moderat. Wenige Sekunden nach einem leichten abdominellen Anprall eines Balles bricht sie bewusstlos zusammen. Bei fehlender Atmung werden durch Laien sofort Maßnahmen der Basisreanimation durchgeführt. Ein Team aus boden- und luftgebundenen Rettungskräften konnte nach insgesamt 50 Minuten Reanimation einen Return of Spontaneous Circulation (ROSC) registrieren. Unter kontinuierlicher Noradrenalininjektion erfolgte der luftgebundene Transport in die Klinik. Die Patientin verstarb jedoch am 3. Tag nach dem Ereignis an dem in der Folge des Kreislaufstillstands aufgetretenen Hirnödem. In der Sektion und den sich anschließenden Zusatzuntersuchungen wurden ein hypoxischer Hirnschaden sowie Zeichen eines Schockgeschehens an lebenswichtigen Organen festgestellt. Außerdem fanden sich Hinweise der kardialen Manifestation einer Infektion mit Parvovirus B19 (PVB19). Schlussfolgerungen Der plötzliche Herztod im Rahmen körperlicher Belastung, wie bspw. bei Sportveranstaltungen, ist ein extrem seltenes Ereignis. Die Anwendung der im professionellen Sportbereich üblichen umfangreichen medizinischen Betreuung wäre im Breitensport mit hohem Aufwand verbunden. Einer symptomatischen Therapie während medizinischer Notfallsituationen in diesem Bereich kommt damit große Bedeutung zu. Das Hauptaugenmerk sollte dabei auf einer funktionierenden Rettungskette mit qualitativ hochwertig ausgeführten Erst- und Folgemaßnahmen sowie einer durch die aufnehmende Rettungsleitstelle telefonisch unterstützten Laienreanimation liegen.

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“…See last year's Swedish issue for Mats Borjesson's take along those lines 1. These are important debates and Drezner strongly rebuts the push by Van Brabandt2 (in The BMJ ) that screening may be futile. Also from USA, at a time when all eyes will be on the election booths, the extraordinary talented Professor Chad Cook explains why we have a long way to go before we can predict injury accurately ( see ).…”

Section: Scandinavian Advances and Congress In Norefjellmentioning

confidence: 99%

Swedish Society for Physical Activity and Sports Medicine: a long history of excellence in sport and exercise medicine

Forssblad

Khan

2016

Br J Sports Med

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Harms and benefits of screening young people to prevent sudden cardiac death

Abstract: Sudden cardiac death of young athletes needs to be avoided but does screening really help? Hans Van Brabandt and colleagues look at the evidence

Cited by 52 publications

References 41 publications

No psychological distress in sportsmen aged 45 years and older after cardiovascular screening, including cardiac CT: The Measuring Athlete’s Risk of Cardiovascular events (MARC) study

No psychological distress in sportsmen aged 45 years and older after cardiovascular screening, including cardiac CT: The Measuring Athlete’s Risk of Cardiovascular events (MARC) study

Plötzlicher Herztod bei 17-jährigem Mädchen – ein Fallbericht

Swedish Society for Physical Activity and Sports Medicine: a long history of excellence in sport and exercise medicine

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