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Competitive Sports: Is the heart Sportive Enough?

Sports have been held in high regard since the very old days and it continues to enjoy the privilege even today. None of the other recreation forms have been able to substitute mankind with another alternative. // Very little is known about the risk of sudden death associated with exercise in young competitors. The benefits versus the hazards of sports activity pose a clinical dilemma.

Recent medical research has reported that adolescents and young adults involved in competitive sport have a two and a half times higher risk of sudden death. The young competitors who died suddenly were affected by silent cardiovascular diseases, predominantly cardiomyopathies. Sport did not directly cause the deaths, but rather it triggered cardiac arrest in athletes with underlying diseases predisposing them to life-threatening ventricular arrhythmias.

In one 17-year study by the Centre for Sports Medicine of Padua involving nearly 34,000 athletes less than 35 years old, over 1,000 were disqualified from competing on health grounds, 621 (1.8%) because the tests revealed relevant cardiovascular abnormalities. ECG is abnormal in up to 95% of patients with hypertropic cardiomyopathy (HCM), which is the leading cause of sudden death in an athlete.

ECG abnormalities have also been documented in the majority of athletes who died from other arrhythmogenic heart muscle diseases. A number of conditions now being picked up by ECG had only recently been discovered, so diagnosis was increasing.

Researchers would shortly be examining the impact on mortality of the increased detection of potentially lethal problems. It is ethically and clinically justifiable to make every effort to recognize in good time the diseases that put these athletes at risk, and to reduce fatalities.

It has therefore been recommended that young athletes involved in competitive sports undergo a vigorous physical examination, a detailed investigation of their persona l and family medical history including an ECG before they participate in such sports activities.

A physician with specific training who could reliably identify clinical symptoms and signs associated with cardiovascular diseases responsible for exercise-related sudden death should perform it. Those who are tested positive according to the criteria should be referred for more extensive tests, and if that confirmed suspicions, barred from competition and training.

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