The higher death rates in football compared with other sporting disciplines can almost certainly be attributed to its popularity and high rate of participation. Football is the most commonly implicated sport in Europe and has claimed the lives of several high profile athletes in the past decade (Table 1). Between 40 to 60% of SCDs occur in athletes under 18 years of age and 33% overall in athletes under 16 years.ĭeaths are most frequent in high intensity dynamic sports of a start-stop nature.
The most vulnerable group of athletes at risk of SCD are adolescent athletes and athletes in early adulthood. Reliable data from the Italian pathology registry in the Veneto region (where pathologists have a particular interest in conditions causing SCD in the young) indicates a prevalence of 1 in 50,000. Sudden cardiac death in sport is rare, however the exact incidence is debatable. MAGNITUDE OF THE PROBLEM AND DEMOGRAPHICS OF THOSE AFFECTED Other causes are: premature coronary disease, aortic rupture from Marfan’s syndrome, aortic stenosis, Wolff-Parkinson-White syndrome and long QT syndrome (Figure 1). arrhythmogenic right ventricular cardiomyopathy 1.Ĭoronary artery anomalies, especially the origin of a coronary artery from the aberrant sinus, are the second commonest cause of SCD in athletes.The main cardiomyopathies implicated in SCD during sport are: The most common causes of SCD in young athletes are the cardiomyopathies (heart muscle disorders) which account for almost 40% of all deaths reported in the literature. In young athletes (aged < 25 years) deaths are most commonly from hereditary or congenital cardiac abnormalities whereas, in older athletes, the commonest cause of death is from coronary artery disease. Up to 90% of all non-traumatic sudden deaths in sport are due to disorders of the cardiovascular system. Unsurprisingly, such tragedies receive considerable media attention headlines frequently allude to the youth of the individual involved, the number of life years lost and the circumstantial paradox, evoking intense emotion within the community at large.
The sudden cardiac death (SCD) of an athlete is a highly emotional and devastating event for families of victims, peers, clubs and the sporting community. Indeed, the risk of a young athlete dying from a structural cardiac abnormality is almost three-times greater than in young sedentary individuals, indicating that the stresses of exercise, notably high levels of circulating catecholamines, coupled with dehydration, high body temperature and minor electrolyte and pH shifts are triggers for fatal cardiac arrhythmias in affected individuals.
SUDDEN DEATH SURVIVAL ARENA LEAGUE 2 PROFESSIONAL
The public cardiac arrest of Bolton professional football player Fabrice Muamba in March of 2012 was a testament of this counter-intuitive fact, although he was fortunate enough to survive. However, athletes harbouring structural or electrical cardiac anomalies may die suddenly during exercise. Participation in regular exercise has appreciable cardiovascular benefits and there is evidence that exercising individuals have a greater lifespan. – Written by Sanjay Sharma and Mathew Wilson, Qatar
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