Sudden Death In Athletes

Sudden Death in Adults and Young Athletes

< 35 y/o = congenital CV disorder, > 35 y/o = atherosclerotic disease

Hypertrophic Cardiomyopathy

L ventricular outflow obstruction, predisposes athlete to arrhythmias

Types of Coronary Conduction Disorders

Wolfe-Parkinson-White Syndrome, Long Q-T syndrome, Paroxysmal supraventricular tachycardia

Long Q-T Syndrome

abnormality of heart's electrical system, prolonged Q-T segment on ECG

Wolfe-Parkinson-White Syndrome (WPW)

accessory conduction pathway contracts more rapidly than AV node and one ventricle contracts just before the other. causes ventricular fibrillation and is fatal unless defibrillation occurs w/in minutes

Impact of Marfan's Syndrome on Athlete

can play if they don't have one or more of the following: 1. aortic root dilation 2. moderate-severe MV regurgitation 3. family hx of sudden death in Marfan relative

Paroxysmal Supraventricular Tachycardia (PST)

defect in discharge pattern of SA node causing >150 bpm at rest, common in children and brought on by caffeine, drugs, alcohol, nicotine, non-lifethreatening

Signs and Sx's of Myocarditis

exercise intolerance, CHF signs, tachycardia, cough, dyspnea, abnormal heart sounds

Clinical Presentation and Management of WPW Syndrome

exertional syncope, increase HR and palpations. medication to limit HR and surgery to obliterate additional conducion pathway

Contributing Factor to Sudden Death

high-intensity exercise, electrolyte imbalance, high body temp, performance enhancers, dietary supplements

Most common cause of Sudden Death

hypertrophic cardiomyopathy

Myocarditis

inflammation of heart muscle. viral, bacterial, protozoal infection

Sudden Death

non-traumatic, nonviolent, unexpected event from cardiac arrest w/in 6 hours of previously witnessed state of normal health

Clinical Presentation of PST

palpations, anxiety, dyspnea, chest pain/tightness, syncope

Impact of WPW on Athlete

restriction of activity, may play if: no hx of palpations or structural abnormalities and don't present w/ tachycardia

Coronary Conduction Disorder

result in arrhythmias that lead to fibrillation and acute heart failure

Marfan's Syndrome

results in connective tissue disease, weak aortic arch, MVP or regurgitation

Signs and Sx's of Long Q-T

ventricular tachycardia, syncope, death