Why athletes are at a greater risk than ever for sudden cardiac death


There has been an alarming increase in incidences of cardiac-related deaths associated with training athletes in the U. S. Look no further than male African-American Division I NCAA athletes, who are now 10-times more likely than their predecessors (1/5,200 vs. 1/52,000) to fall victim to sudden cardiac death (SCD).

The key question is who is an athlete? for most an athlete brings up the image of a young 20-something in college. The reality now is that with the extent of ever increasing exercising populations in our country (although we still have a ways to go) can and should include a much larger group of people as being defined as an athlete. I certainly consider myself one and I am 48 y/o. Lets see: One definition of athlete commonly accepted is: "One who participates in an organized team or individual sport that requires competition against others as a central component, places a high premium on excellence and achievement, and requires some form of systematic (and usually intense ) training". This to me would define as athletes all of my cycling, swimming and running friends and thousands who for example now are avid triathletes, the ever-growing CrossFit clan, the hundreds of thousands, like my wife, fervidly attending gym classes and all "recreational" runners that indeed train for any moderate to long distance event. All of these would fit within the definition of athletes and hence should be aware of the albeit rare but important events of sudden cardiac death or arrest.

The issue, according to the latest recommendation by the American College of Cardiology and American Heart Association is weather you can start a training regime safely or not is a very common one and certainly an important one. Are you over or under 35 y/o, do you have a Family history of cardiac problems? Is your training progressing well or have you noted problems related to unexpected heart rates or dyspnea out of what is to be expected? These are some of the basic issues addressed recently by an extensive review of the known data regarding sudden cardiac death (SCD) and sudden cardiac arrest (SCA) in the US population when it comes to training athletes. I believe that the last thing in your mind when you are about to start exercising is any concern for your health and safety since the whole idea is to get healthier through exercise. There is ample data about the extensive benefits of exercise and how it can promote health and its role in preventing medical conditions and certainly improve quality of life. In this modern time there is no excuse not to be aware however, who should be screened before starting participation. There are several factors to be involved and most certified trainers and coaches would and should know who warrants a pre-evaluation in order to proceed safely.

My advice is to simply ask your trainer or your primary MD before you start but certainly also if things are not progressing as expected by your trainer or coach.

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Melvin A. Martinez-Castrillon, MD