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Christian C. Evans and Sandra L. Cassady

Objective:

To describe the underlying conditions that predispose athletes to sudden cardiac death (SCD) and review signs and symptoms that indicate an athlete is at risk.

Data Sources:

MEDLINE, the Los Angeles Times and Triathlon Times archives, and other sources identified in the references of articles initially located therein. A total of 43 references were included.

Conclusions:

Most cases of SCD in younger athletes (≤35 years) are attributable to multiple hereditary conditions, with familial hyper-trophic cardiomyopathy being the primary cause, whereas the major cause of SCD in older athletes (>35 years) is coronary artery disease. Health-care professionals evaluating athletes should pay particular attention to past medical and family history. Items in an athlete’s screening that suggest increased risk include a history of chest pain, syncope, excessive shortness of breath, irregular heart rate or murmur, or a history of SCD in an immediate family member.

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Thomas Terrell, John Pitt and Irfan Asif

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Robert L. Kronisch

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Julianna Shappy

Edited by Lindsey E. Eberman

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Gary Allen, Kristy Smith, Brady Tripp, Jason Zaremski and Seth Smith

Key Points ▸ Coronary artery anomalies are among the leading causes of sudden cardiac death. ▸ Coronary artery anomalies are rarely identified on preparticipation screening. ▸ Patients can possibly return to sport with appropriate diagnosis and treatment. Sudden death in young, competitive athletes

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Bradford Strand, Shannon David, Katie J. Lyman and Jay M. Albrecht

The purpose of this original research was to survey high school coaches in four states in the Midwest region of the United States regarding their knowledge of first aid, cardiopulmonary resuscitation (CPR), and use of an Automated External Defibrillator (AED) as well as confidence in managing/treating emergency situations. Responses to general knowledge inquiries revealed that coaches were able to accurately answer questions related to return to play, level of consciousness, external bleeding, and cardiac arrest. However, coaches were unable to correctly answer questions specific to rest, ice, compression, and elevation (RICE) and also misidentified information related to pediatric AED use. Because sudden cardiac death is the leading cause of death and has been linked to lack of bystander intervention, the results of this project should be considered by coaches and administrators to implement certification and continuing education for high school coaches. Finally, coaches who were certified in first aid, CPR, and AED were more confident in treating an individual who required care compared with coaches not certified. Therefore, individuals who coach at all levels of sport and recreational activities should consider formal training and certification.

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Anthony Rossi, Tina Claiborne and Jamie Fetter

Key Points ▸ Sudden cardiac death (SCD) is the leading cause of sudden death in young athletes and occurs three times more often in athletes than in nonathletes. ▸ Physical exams, personal history, and family history alone may not be enough to identify risk factors. ▸ Of patients with SCD, 80% are

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Anthony Rossi, Tina Claiborne and Jamie Fetter

standard of care. Research shows that 80% of patients who suffer sudden cardiac death are asymptomatic until cardiac arrest occurs. This may suggest that screening by history and physical examination alone is insufficient to identify athletes with life-threatening cardiac conditions. 10 The cardiac