Sudden cardiac death athletes: a systematic review

Abstract

Previous events evidence that sudden cardiac death (SCD) in athletes is still a reality and it keeps challenging cardiologists. Considering the importance of SCD in athletes and the requisite for an update of this matter, we endeavored to describe SCD in athletes. The Medline (via PubMed) and SciELO databases were searched using the subject keywords "sudden death, athletes and mortality". The incidence of SCD is expected at one case for each 200,000 young athletes per year. Overall it is resulted of complex dealings of factors such as arrhythmogenic substrate, regulator and triggers factors. In great part of deaths caused by heart disease in athletes younger than 35 years old investigations evidence cardiac congenital abnormalities. Athletes above 35 years old possibly die due to impairments of coronary heart disease, frequently caused by atherosclerosis. Myocardial ischemia and myocardial infarction are responsible for the most cases of SCD above this age (80%). Pre-participatory athletes' evaluation helps to recognize situations that may put the athlete's life in risk including cardiovascular diseases. In summary, cardiologic examinations of athletes' pre-competition routine is an important way to minimize the risk of SCD.

Inhibition of connexin 43 in cardiac muscle during intense physical exercise

“…Epidemiological studies show that the relative risk for sudden death increases during or shortly afterwards of an exercise bout (Sadaniantz & Thompson, ). These exercise‐associated acute cardiac events generally affect individuals with structural cardiac disease (Ferreira et al., ). However, the mechanism underlying the acute effect of exercise in triggering ventricular arrhythmias has not been unraveled.…”

Myocardial infarction caused by myocardial bridging in a male adolescent athlete

“…1 However, the patients involved in previous reports were all adults above 30 years of age and there was no report of MI induced by myocardial bridging in adolescent. In addition, cardiovascular causes of sudden death in athletes less than 35 years of age commonly include hypertropical cardiomyopathy, coronary artery anomalies, increased ventricular mass, right ventricular arrhythmogenic dysplasia, Marfan syndrome, the long QT and Brugada syndrome, 5 and there has been no report of MI induced by myocardial bridging in athletes. To our knowledge, the present case, for the first time, showed that MI could be induced by myocardial bridging in a male adolescent athlete without any risk factors of CAD.…”

Repolarization Perturbation and Hypomagnesemia after Extreme Exercise

“…There are several studies reporting an increased risk of SCD during strenuous exercise (1,14); however, the theories attempting to explain this phenomenon are speculative (30). Until now, no plausible explanation of this phenomenon has been advanced.…”