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Sudden cardiac death in athletes

Can it be prevented by screening?

Plötzlicher Herztod bei Athleten. Kann er durch Vorsorgeuntersuchungen verhindert werden?

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Abstract

In 1982, a nationwide program of preparticipation screening of all individuals embarking in competitive sports activity was launched in Italy. The screening protocol includes athlete’s personal and family history, physical examination, and twelve-lead electrocardiogram (ECG) as first-line examination; additional tests such as echocardiography or exercise testing are requested only for subjects who have positive findings at the initial evaluation. This screening algorithm, which has been used for preparticipation evaluation of millions of Italian athletes over a period of > 25 years has provided adequate sensitivity and specificity for detection of athletes affected by potentially dangerous cardiomyopathy or arrhythmia at risk of athletic-field death and has led to substantial reduction of mortality of young competitive athletes (by approximately 90%), mostly by preventing sudden death from cardiomyopathy.

Zusammenfassung

1982 wurde in Italien ein nationales Programm mit dem Ziel eingeführt, alle Individuen, die mit Wettkampfsport beginnen, einer medizinischen Vorsorgeuntersuchung zu unterziehen. Dieses Vorsorgeprotokoll beinhaltet als Basisuntersuchung die persönliche und familiäre Anamnese des Athleten, eine körperliche Untersuchung sowie ein Zwölf-Kanal-EKG; bei positiven Befunden werden weitere Untersuchungen vorgenommen, etwa eine Echokardiographie oder ein Belastungstest. Der Screeningalgorithmus, der seit > 25 Jahren bei Millionen Italienern angewandt wird, hat eine ausreichende Sensitivität und Spezifität gezeigt, um Sportler detektieren zu können, die aufgrund einer Kardiomyopathie oder von Rhythmusstörungen ein erhöhtes Risiko aufweisen, auf dem Wettkampfplatz zu versterben. Das Vorsorgeprogramm hat zu einer substantiellen Reduktion (um ca. 90%) von Todesfällen bei jungen Wettkampfsportlern geführt, insbesondere durch Verhinderung eines plötzlichen Herztods aufgrund einer Kardiomyopathie.

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Authors and Affiliations

  1. Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy

    Domenico Corrado MD, PhD, Federico Migliore & Michela Bevilacqua

  2. Cardiovascular Pathology, Department of Medical-Diagnostic Sciences, University of Padua, Padova, Italy

    Cristina Basso & Gaetano Thiene

  3. Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Medical School, Via Giustiniani, 2, 35121, Padova, Italy

    Domenico Corrado MD, PhD

Authors
  1. Domenico Corrado MD, PhD
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  2. Federico Migliore
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  3. Michela Bevilacqua
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  4. Cristina Basso
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  5. Gaetano Thiene
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Corresponding author

Correspondence to Domenico Corrado MD, PhD.

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Corrado, D., Migliore, F., Bevilacqua, M. et al. Sudden cardiac death in athletes. Herz 34, 259–266 (2009). https://doi.org/10.1007/s00059-009-3236-3

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