Incidence of sudden cardiac arrest (SCA) occurs without warning symptoms in young participants, with sports a trigger in only a minority of cases and standard cardiovascular risk factors found in over half of patients, a recent study found. The prospective study included participants who suffered SCA between ages 5-34 years in the Portland, OR, area between 2002 and 2015. Researchers evaluated the association of standard CV risk factors and SCA, and sports as a trigger for SCA in the young. They found:
- Of 3,775 SCAs in all age groups, 186 (5%) occurred in the young (mean age ∼26 years, 67% male).
- In young SCA, overall prevalence of warning signs before SCA was low (29%); and only 26 (14%) were associated with sports as a trigger.
- The remainder (n=160) occurred in other settings categorized as non-sports.
- Sports-related SCAs accounted for 39% of SCAs aged ≤18 years, 13% of SCAs aged 19-25 years, and 7% of SCAs aged 25-34 years.
- Overall, the most common SCA-related conditions were sudden arrhythmic death syndrome (31%), coronary artery disease (22%), and hypertrophic cardiomyopathy (14%).
- There was a high overall prevalence of established CV risk factors with ≥1 risk factor in 58% of SCA cases.
Jayaraman R, Reinier K, Nair S, et al. Risk factors of sudden cardiac death in the young: A multiple-year community-wide assessment. [Published online ahead of print December 21, 2017]. Circulation. doi:10.1161/CIRCULATIONAHA.117.031262.
SCA remains a vexing problem with tragic outcomes and very little data available to identify high-risk groups ahead of time. The current study is important in showing that participation in sports accounts for only a minority of SCA in young people. The unanswered question for SCA in the young is whether screening can be effective, through a combination of physical exam—which primarily looks to detect a murmur associated with hypertrophic cardiomyopathy—and EKG, to look for long QT syndrome. Currently such screening is not standard and is the subject of much research.1—Neil Skolnik, MD
- Ackerman M, et al. Sudden cardiac death in the young. Circulation. 2016;133:1006-1026. doi:10.1161/CIRCULATIONAHA.115.020254.