Prevention and Management of Sudden Cardiac Death in Athletes

Alwar Thiagarajan, A. Prakash, G. Janani, Vikram Rao, S. Arumugam
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Abstract

Sudden cardiac death (SCD) is the biggest challenge of all sports emergencies, as it is the leading cause of preventable deaths in both professional and recreational athletes. There is also an ongoing concern about COVID-19-associated cardiac pathology among athletes because myocarditis is an important cause of SCD during exercise. Hypertrophic cardiomyopathy represents 24% of SCD and Sudden Unexplained Death (normal heart at autopsy) represents 34% of SCD. To make sports participation safer, it is important to synergistically combine primary prevention of SCD by pre-participation identification of athletes affected by at-risk cardiomyopathies and secondary prevention with backup defibrillation of unpredictable sudden cardiac arrest on the field. The prompt application of an automated external defibrillator itself is associated with a greater likelihood of survival. With the advancement in the field of sports cardiology, the implantation of implantable cardioverter defibrillator has been promising in getting the athlete back on the field including in contact sports. Hence, knowledge of primary and secondary prevention is of great importance in reducing the incidence of SCD as well as improvising existing strategies.
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运动员心源性猝死的预防与管理
心源性猝死(SCD)是所有体育突发事件中最大的挑战,因为它是职业和休闲运动员可预防死亡的主要原因。由于心肌炎是运动期间SCD的重要原因,因此人们对运动员中与covid -19相关的心脏病理也一直感到担忧。肥厚性心肌病占SCD的24%,不明原因猝死(尸检时心脏正常)占SCD的34%。为了使体育参与更安全,重要的是将SCD的一级预防(通过赛前识别受高危心肌病影响的运动员)和二级预防(在赛场上对不可预测的心脏骤停进行辅助除颤)协同结合起来。及时应用自动体外除颤器本身与更大的生存可能性有关。随着运动心脏病学领域的进步,植入式心律转复除颤器的植入在运动员重返赛场,包括在接触性运动中,已经有了很大的希望。因此,了解一级和二级预防对于降低SCD发病率以及改进现有策略非常重要。
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