Sudden death (SD) is defined as an
unexpected fatal event that occurs in an apparently healthy person. The
relationship between SD and sports is time-bound, as most of these events occur
during or immediately after training or competition. These cases consistently
make headlines in sports media, generating uncertainty in this community, as it
is difficult to understand how young, energetic and apparently healthy people
can die while playing their usual sports. So it is necessary to invest
sufficient resources to address the problem through a multidisciplinary
approach, identifying individuals at high risk who may benefit from preventive
treatment strategies.
This paper described
the case of sudden death in a young professional athlete who was successfully
aided and resuscitated outside the hospital, and reviewed the literature about
sudden death in sports. A 16-year-old boy, competing on an elite rowing team,
felt dizzy and lost consciousness during a monitored training session. Upon confirming
that the boy had no pulse or breathing, his coach immediately proceeded to
perform basic cardiopulmonary resuscitation (CPR) and another person present at
the scene provided an automatic external defibrillator, and the boy was
administered two pulses of 300 Joules. After the second pulse, the boy resumed
spontaneous cardiac rhythm and breathing.
The authors also
searched for Sudden Death (according to the International Classification of
Diseases (ICD-9 and ICD-10)) in the hospital but found no other relevant cases.
They performed a literature search on the state of the art in sudden death
(Google Scholar, PubMed, LILACS, Scielo and the Revista Española de
Cardiología). Although the authors observed that the prevalence of
sudden death was not very high, it still represented a potentially avoidable
event. An adequate medical examination prior to regular sporting practice can
decrease the incidence of sudden death in athletes under the age of 35. Data
available in the literature support medical check-ups that include
history-taking, physical examination and electrocardiogram. The findings of
this evaluation may also prompt further assessment (electrocardiograph,
ergometry).
In summary, the
authors propose: 1) a pre-participation medical check-up for all competitive
athletes as a pre-condition to their registration in nationally recognized
sporting events; 2) the performance of a basic physical examination, assessing
key medical indicators; 3) performance of a 12-lead resting ECG. In short, identifying
people at high risk would enable the medical community to persuasively
discourage them from participating in sports, thereby reducing their risk and
preventing new cases of SD.
Article by María Elena
Caparrós-Hernández, et al, from Spain.
Full access: http://t.cn/EtY9kKy
Image by richseow, from Flickr-cc.
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