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New Findings on Sports-related Sudden Cardiac Arrest

The study suggests that there is a high-benefit to low-risk nature with sports activity in middle age, since the portion of sports-associated SCA is relatively small compared to the overall SCA burden…

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Sudden Cardiac Arrest (SCA) accounts for almost 50% of cardiovascular mortality, but there have be no studies evaluating sports-related SCA in middle age subjects in the United States. In Europe, they found that the largest burden of sports-related SCA events are seen among the middle-aged participants. An international team of American and French researchers used a 12-year prospective study of SCA to compare the characteristics and outcome of SCA during sports in middle age and other non-sports related SCAs in the United States.

Data from the Oregon Sudden Unexpected Death Study (Oregon-SUDs), a community-based prospective study of outpatient SCA between February 2002 and January 2013, was used. Sources included EMS response, Medical Examiner’s office, and the ER departments of all 16 local hospitals in Oregon. Comprehensive evaluation is performed for each case of SUD and included only sport-related SCA individuals between the age of 35 and 65 years old (middle age group). SCA was defined as a sudden unexpected pulseless condition; and only SCA during sports or within one hour of sports activity cessation were considered. Subjects with known non-cardiac causes of arrest were excluded; and previous medical history was obtained from inpatients and outpatient medical records.

The results showed that only 5% of SCA in the middle age group was due to sport-related activity. The mean age was 51.1 years, and the rate was significantly higher among men compared to women. The study showed that these sports-related events are more likely to be witnessed, and survival to hospital discharge was higher than non-sports related SCA. The data also showed that 16% of the sports-related SCA had known heart conditions, 56% had 1 or more cardiovascular risk factor, and about 36% had some kind of symptom during the week preceding the SCA event.

The study suggests that there is a high-benefit to low-risk nature with sports activity in middle age, since the portion of sports-associated SCA is relatively small compared to the overall SCA burden. Authors suggest that exercise and sports activity should only come after an assessment of possible musculoskeletal limitations, and that targeted educations could maximize both safety and acceptance of these activities in the middle age population.

Practice Pearls:

  • There is a high benefit and low risk nature of sports activity, as seen by the small portion of sports-associated SCA in the middle age subjects compared to the overall SCA burden.
  • The study showed that about 16% had previous known heart conditions, and about two-thirds had either a risk factor or some kind of symptom 1 week prior to the sport-related SCA event.
  • Targeted education would allow for both safety and acceptance of sports activity in the middle age population.

Marijon E, Uy-Evanado A, Reineir K, Teodorescu C, et al. Sudden Cardiac Arrest During Sports Activity in Middle Age. Circulation AHA. 6 April 2015. Web. 14 April 2015.