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Clemens von Schacky, Maximilian Kemper, Robert Haslbauer and Martin Halle

The Omega-3 Index is defined as erythrocyte eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and represents an individual’s status in these two marine omega-3 fatty acids. A target range of 8 to 11% has been suggested, because values below predispose to cardiovascular events, especially sudden cardiac death, as well as to suboptimal brain function, like prolonged reaction times or even depression. Compared with the general population, elite athletes have an increased incidence of sudden death. The Omega-3 Index has not yet been investigated in elite athletes. In an exploratory approach, we determined the Omega-3 Index in 106 consecutive German national elite winter endurance athletes presenting for preparticipation screening, using a well-established analytical procedure (HS-Omega-3 Index). Surprisingly, only one athlete had a value within the target range, but all others had values <8%. We conclude that we have identified a deficiency of EPA and DHA in these elite athletes. This deficiency presents a potential option for prevention of cardiovascular events such as sudden cardiac death, and improving aspects of brain function. It will be important to scrutinize our finding by more thorough epidemiologic studies and appropriate intervention trials.

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Thomas Rowland

The two articles in the area of cardiovascular physiology and disease in youth were chosen for commentary because of their exploration of new approaches to the diagnosis and management of cardiovascular derangements in young persons. The first, by Hinds et al., describes the potential clinical importance of detection of cardiovascular changes during exercise testing in adolescent athletes following concussions. This approach might prove useful in establishing safe return-to-play guidelines. The second, a review article by Van De Schoor et al, evaluates the frequency of myocardial scarring in athletes, some of adolescent age, which is a recognized risk factor for sudden cardiac death. These findings support other evidence indicating that sports participation per se might rarely increase the risk of such tragedies. Clearly more research is indicated by the information raised in both of these articles, but their importance to clinical medicine is obvious.

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Christian C. Evans, Lisa Schwarz and Minal Masihi


Sudden cardiac death in athletes may be preventable if healthcare providers perform a thorough screening of the cardiovascular system during routine athlete evaluations.


Determine the adequacy of routine screening of athletes for heart disease by athletic trainers (ATs) and physical therapists (PTs).

Design, Participants, Setting, and Methods:

National Athletic Trainers Association and Sports Physical Therapy Section members were surveyed using a stratified sampling technique via e-mail and postal mail.


ATs performed significantly higher than PTs on the composite screening score (CSS; mean of 13 items) as well as on 9 of 13 individual items. Logistic regression analysis revealed that “involvement in preparticipation screenings for sports (PPSS)” was most closely related to CSS (P < .01) and controlling for this factor in the ANOVA eliminated differences between the professions.


Clinicians working with athletes who are not involved in PPSS may not adequately screen these patients for heart disease.

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articles for this quiz can be found in this issue of IJATT . Choose the best answer for each question. THIS IS JUST A PAPER VERSION FOR YOUR PERUSAL: YOU MUST TAKE THIS QUIZ ONLINE. 1. As noted by Allen et al., an anomalous right coronary artery (ARCA) more often leads to sudden cardiac death than an

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Kelly L. Holzberger, Kim Keeley and Martin Donahue

tachycardia, ventricular fibrillation, and sudden cardiac death. 3 , 4 For this reason, healthcare providers, especially those caring for active patients, must be educated about the recognition, diagnosis, and treatment of SVT. Currently, the literature is lacking case reports demonstrating the effective

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Rossi et al., in the United States, the use of more advance diagnostic testing on all athletes at the time of preparticipation examination (PPE) is not the current standard of care. a. True b. False 8. Research has shown that _______ of patients with sudden cardiac death (SCD) are asymptomatic until

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Riana R. Pryor, Summer Runestad, Bethany A. Chong Gum, Nathan J. Fuller, Moon Kang and Jennifer J. Beck

personnel or unqualified nonmedical providers. 10 With sudden cardiac death, head and neck injuries, and exertional heat stroke as the top three causes of sudden death in secondary school athletics, medical care for student-athletes from appropriate medical providers (i.e., ATs) is imperative. 5 California

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Seyed Mohsen Hosseini, Mojtaba Azizi, Ali Samadi, Nahid Talebi, Hannes Gatterer and Martin Burtscher

-Arrese A . Cardiac biomarker response to intermittent exercise bouts . Int J Sports Med . 2011 ; 32 ( 5 ): 327 – 31 . PubMed doi:10.1055/s-0030-1263138 10.1055/s-0030-1263138 21547864 6. Ellison SR . Sudden cardiac death in adolescents . Prim Care Clin Office Pract . 2015 ; 42 ( 1 ): 57 – 76

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Duncan Simpson and Lauren P. Elberty

(approximately 18 deaths per year) with sudden cardiac death (SCD) being the common cause, while other reasons included sleep issues, gunshots, drug abuse, suicide, blunt trauma, sickle cell trait, drowning, and heat stroke. Although 18 deaths per year is a small number given there are over 460,000 NCAA student

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Susan Sullivan Glenney, Derrick Paul Brockemer, Andy C. Ng, Michael A. Smolewski, Vladimir M. Smolgovskiy and Adam S. Lepley

“working out”[ti] OR “workout”[ti] OR “workouts”[ti] OR firefighter*[ti]) AND (“Sudden cardiac death” OR SCD OR “troponin I” OR “troponin t” OR “troponin complex” OR “p selectin” OR “lipid panel” OR “fasting glucose” OR insulin OR BNP OR fibrinogen OR “cardiorespiratory fitness” OR crp OR “c reactive