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sudden cardiac death in atheletes

sudden cardiac death in atheletes. BY PROF.DR . KAMAL MAHMOUD AHMAD. HEAD OF THE CARDIOLOGY & ANGIOLOGY UNIT MEDICAL RESEARCH INSTITUTE ALEXANDRIA UNIVERSITY. SUDDEN CARDIAC DEATH IN YOUNG ATHLETES. A competitive athlete is one who participates in an organized team

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sudden cardiac death in atheletes

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  1. sudden cardiac death in atheletes

  2. BY PROF.DR. KAMAL MAHMOUD AHMAD

  3. HEAD OF THE CARDIOLOGY & ANGIOLOGY UNIT MEDICAL RESEARCH INSTITUTE ALEXANDRIA UNIVERSITY

  4. SUDDEN CARDIAC DEATH IN YOUNG ATHLETES A competitive athlete is one who participates in an organized team or individual sport that requires regular competition against others and requires vigorous training

  5. What do these elite athletes look like? athletes had a 46% larger left ventricle than non-conditioned people. They also had a 33%increase in stroke volume. Resting heart rates is low

  6. How do we measure the Athletes Heart?a The size of the left ventricle when fully expanded, the thickness of its walls, and the amount of blood it pumps with each beat, (called stroke volume) are all key stats in assessing the heart. A technique using ultra sound technology called echocardiography allows doctors to watch the heart in action, freeze the image, and then take measurements to establish the athlete’s heart.

  7. DEMOGRAPHICS • Sudden cardiac death occurs most frequently during basketball and football • Majority of deaths occur in men • Most athletes are of high school age at the time of death • Majority of the athletes who incur sudden death have been free of cardiovascular symptoms • Collapse is usually associated with intense physical exertion and most commonly occur in the afternoon and early evening hours

  8. Cause of Death • 85% died of cardiovascular causes • 15% died of non cardiovascular causes -

  9. CRADIOVASCULAR CAUSES

  10. Cardiac History Screening Previous murmur or high BP Family history of early MI or sudden death Exercise-related symptoms

  11. CASE PRESENTATION

  12. TIMING OF SCD IN ATHLETES • 90% of deaths among young athletes occur during training or competition • These observations substantiate the finding that in the presence of certain cardiovascular diseases, vigorous physical exertion represents a trigger for lethal arrhythmias and sudden death on the athletic field

  13. Many of the athletes who've died playing their sport either had very subtle symptoms they didn't understand,or they didn't appreciate the risk. • The events are sudden and tragic. • There are cardiac programs specifically designed for these athletes to catch their condition before it's too late.

  14. In SCA, the heart suddenly stops beating normally. The electrical impulses that control the rhythm of the heart become so disorganized that the heart can no longer effectively pump oxygenated blood to the brain and the body's vital organs, and death occurs

  15. Etiology of life threatening arrhythmias and sudden cardiac death • Coronary artery disease. (MI) • Heart failure. Cardiomyopathies. Hypertrophic cardiomyopathy (HCM) Dilated cardiomyopathy (DCM) Arrhytythmogenic RV cardiomyopathy (ARVD) Primary electrophysiologic disorders. Long QT syndrome Brugada syndrome • Aortic stenosis • Anomalous origin of coronary arteries

  16. Coronary artery disease. • 8o % of fatal arrhythmias and SCD • The culprit arrhythmia is; • VT/VF in 95% and • Asystole in 5 %

  17. Predictors of arrhythmias • LARGE infarction. • Impaired LV systolic function. • Presence of occluded artery.

  18. Anomalous Coronary arteries Type of Anomalous Coronary arteries • Origin of the left main coronary artery (LMCA) from the right or non coronary sinus • Origin of the right coronary artery (RCA) from the left coronary sinus. • Both coronary arteries arising from the same coronary ostium . • Absent right coronary artery in one case.

  19. Cardiomyopathies Cardiomyopathies are defined by the World Health Organization (WHO) as Diseases of the myocardium which result in cardiac dysfunction.

  20. The WHO Classification of Cardiomyopathies Includes: • HYPERTROPHIC. • DILATED. • RESTRICTIVE. And • Arrhythmogenic right ventricular cardiomyopathies.

  21. HYPERTROPHIC CM • Prevalence and Genetics • Most common cause of sudden death in young athlete • Prevalence: 0.2% (1:500) in the adult general population • Most common genetic cardiovascular disease • < 1% of patient in cardiology practice • Genetics: autosomal dominant trait, caused by mutations in genes encoding proteins of the cardiac sarcomeres

  22. In hypertrophic Cardiomyopathy • The ventricular walls are hypertrophied. • The cavity is small. • The ventricular function is • normal or hyperkinetic.

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