What are the Causes of Sudden Death in Athletes?

The sudden death of an athlete depends on different causes and factors, according to their age and the sport they practice. But, is it possible to prevent this?
What are the Causes of Sudden Death in Athletes?

Last update: 29 April, 2021

You probably remember some case of an elite athlete that died in the middle of a game or training. This kind of event tends to be fairly high profile and fill the front pages of newspapers. However, the sudden death of an athlete is an extraordinarily rare occurrence.

The causes of sudden death can be different depending on whether the athlete is younger or older than 35 years old. Below, we tell you all about this phenomenon and its possible causes.

What is sudden death?

First of all, we should define sudden death. Basically, this is when a person’s heart stops in an unexpected and sudden way. It usually happens to healthy people that are in a good state of health. This includes athletes.

The medical definition is “a death that occurs alongside the onset of symptoms, or the unexpected death of an apparently healthy person”.

Victims of sudden death usually lose complete consciousness, don’t respond to any stimulus, and keep their eyes open or shut. The color of their skin turns violet-blue, as they stop breathing.

Defibrillation has helped to save many people that have momentarily died as a result of a sudden death. But, this has to be done as soon as the first symptom(s) starts. An electric shock to the heart makes the muscle work again, and recover its normal rhythm.

If there isn’t a defibrillator available, another option would be to administer cardiopulmonary resuscitation (CPR) to prolong the time until you’re able to get the apparatus.

Specialists calculate that for every moment wasted in attending to a potential sudden death patient, there’s a 10% less chance that the pateint will live. 

another man lying on the floor with someone administrating CPR with gloves on

What are the causes of sudden death?

According to a study published in the Spanish Journal of Cardiology (Revista Española de Cardiología) in 2002, cardiovascular illness is the most common cause of sudden death for athletes. But, it’s also that for people that don’t do regular physical activity.

In athletes under 35 years old, congenital anomalies in coronary arteries and cardiomyopathies are the most common. However, in those older than 35, acquired atherosclerotic coronary disease and coronary atheromatous disease (CAD) are the most common. And in almost every case, an arrhythmia can happen in a structurally normal heart.

A lot of the diagnostics are based on a macroscopic exam. This is a specific study that talks about the autopsies of people who died as a result of sudden death as they were playing sport – or the hour after – in Spain.

In the cases of those who die from sudden death as a result of CAD, some of the injuries that appear in the studies were as follows: more than 75% reduction of the lumen atheroma plaque, scars from a heart attack, coronary thrombosis, and acute myocardial infarction.

In the same study, specialists gathered information from 61 cases of people suddenly dying during sport over 6 years. 59 of them were men, 21 were cyclists, and 13 played football. The average age of the patients was 30 years old.

The main illness was CAD, at an average age of 44 years old; in these cases, the most common injury was chronic coronary artery stenosis. The second illness was CAM, with biventricular involvement.

Is it possible to prevent sudden death in athletes?

cardiologist checking heart palpitations

As a first step, it’s important to have a medical exam before competing or participating in any sports. This way, the specialist will be able to detect certain abnormalities that can eventually cause the fatal event.

However, this doesn’t mean that it’s possible to prevent 100% of sudden death cases in athletes. What we can do, though, is ensure that more people know how to administrate cardiopulmonary resuscitation (CPR). Especially in places where there isn’t a defibrillator, which should actually be obligatory in any space where people practice sport of any type or level.

Overall, the most efficient way of reducing a person’s risk of suffering from sudden death is, paradoxically, exercise and especially at an early age. By doing this, you’re able to control cardiac risk factors such as hypertension, diabetes, cholesterol, and obesity.

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