‘Periodic screening’ required to avert sudden cardiac deaths in athletes

Dr. Lakshmi Sundar emphasizes the importance of exercise for health while addressing the risk of sudden cardiac death in athletes.

Lakshmi Sundar

Exercise is a vital tool for promoting health and well-being. It improves cardiovascular risk factors like lipid levels, hypertension, insulin sensitivity, and weight. Multiple studies have established a positive correlation between moderate aerobic exercise and reduced risk of coronary artery disease. However, instances of sudden cardiac death (SCD) in athletes, while rare, remain a significant concern that requires careful attention and preventive measures.

SCD is defined as a sudden, unexpected death due to cardiac causes or sudden death in a structurally normal heart with no other explanation and a history consistent with cardiac-related death. The most common cause of SCD is sudden cardiac arrest (SCA), characterised by an unexpected circulatory arrest typically due to cardiac arrhythmia, occurring within an hour of symptom onset. SCA may be reversible with prompt medical intervention, particularly defibrillation.

SCD in athletes draws unwanted media attention and emotionally affects the athlete and the family. An activity that is normally associated with health can draw negative attention.

What does exercise do?

What happens during exercise? During vigorous physical activity, there is a substantial increase in sympathetic nervous system activity. In predisposed individuals, this surge can trigger arrhythmias and potentially lead to sudden cardiac arrest. Understanding this mechanism is crucial for prevention and risk assessment.

The risk factors for SCA and SCD include coronary artery disease, a genetic predisposition, hypertrophic cardiomyopathy, and arrhythmias; pre-existing heart conditions, weight issues, high-intensity exercise without proper training, a history of smoking (current or past), and increased ambient temperature.