Sudden cardiac death (SCD) in the athlete / active individual, although uncommon, is the most devastating sport related event. Evidence suggests that athletes / active individuals may be 4.5 times more likely to suffer SCD than their less active counterparts. In recent years there have been a number of high profile SCDs (some aborted), bringing the issue into the public eye like never before.

 

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The American Heart Association, European Society of Cardiology, International Olympic Committee, and most European cardiological and sports federations recommend cardiac screening prior to participation in any competitive sports.

 

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12-lead ECG, in addition to history taking and physical examination has a substantial influence on early identification of asymptomatic active individuals who have potentially lethal heart disorders distinctly manifesting with heart abnormalities, such as cardiomyopathies, pre-excitation syndromes and cardiac ion channel disorders.

 

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In Italy anyone participating in sport below the age of 35 is required by law to undergo annual health screening. This approach has led to a 90% reduction in SCD.

 

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An ECG will identify the vast majority of abnormalities that may predispose an asymptomatic individual to SCD. Evidence shows that of the remaining individuals that may not be identified, have a significantly lower chance of suffering SCD, without first exhibiting a gradual onset of symptoms, allowing an individual to seek medical assessment. A study into hypertrophic cardiomyopathy (which accounts for the majority of SCDs in asymptomatic, young, active individuals) with a normal ECG, found the number of cardiac related deaths at 10 years to be zero. What this shows, is that a normal ECG is very reassuring.