August 09, 2018
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Screening identifies diseases linked to sudden cardiac death in adolescent athletes

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CV screening identified diseases associated with sudden cardiac death in children who played soccer, according to a study published in The New England Journal of Medicine.

Aneil Malhotra, MB, BChir, PhD, clinical lecturer in cardiology at St. George’s, University of London, and colleagues analyzed data from 11,168 children (mean age, 16 years; 95% boys) aged 15 to 17 years who played soccer at clubs associated with the English Football Association from 1996 to 2016. Children underwent a physical examination, echocardiography and ECG, and they completed a health questionnaire.

Data were used to categorize children as normal, further evaluation needed or cardiac disease detected. Those who required further investigation went to regional specialist centers and underwent further testing based on their suspected condition.

Cardiac disorders associated with sudden cardiac death were seen in 0.38% of children, and 2% of children had other cardiac disorders, including valvular abnormalities or congenital septal abnormalities.

During a mean follow-up of 10.6 years, 23 deaths occurred, of which 35% were related to cardiac disease. The most common cause of sudden cardiac death was cardiomyopathy (88%). Most children who died from sudden cardiac death (75%) had normal cardiac screening results. The mean time between cardiac screening and sudden cardiac death was 6.8 years for children who died from cardiac disorders.

After 118,351 person-years of follow-up during a 20-year period, the incidence of sudden cardiac death in children who were previously screened was 1 per 14,794 person-years, or 6.8 per 100,000 children.

“Sudden cardiac death may be more common in some sports than in others; these results in adolescent soccer players are similar to findings previously reported in male basketball players,” Malhotra and colleagues wrote. “The National Collegiate Athletic Association in the United States adopted a policy in 2014 requiring all affiliated institutions to report cases of catastrophic injury or death. Such mandatory reporting initiatives across other sporting organizations would offer an important source of prospective data in already well-defined populations.” – by Darlene Dobkowski

Disclosures: Malhotra reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.