Sudden deaths in athletes: an Italian study designs prevention

Sudden death in sport happens, and it is a disruptive event. Because the victims are often very young and because they are thought to have passed clinical tests to be on the pitch to play. Studying who is at risk is a must, and the Sport Medicine of Ulss 2 of Padua, the regional reference center for sport in young people with heart disease, did so – by examining more than 22,000 young athletes – with a study conducted in collaboration with the University of Padua on the significance of sports medical screening in the prevention of “sudden deaths” in sports.

The research, published in the scientific journal European Heart Journal with an immediate echo in the international cardiology community, led by the team of Patrick Sartodirector of Sports Medicine of ULSS 2, in collaboration with Dominic Conraddirector of the UOSD Genetic Center for Arrhythmic Cardiomyopathies and Sports Cardiology, e Alessandro Zorziboth from the Department of Thoraco-vascular Sciences and Public Health of the University of Padua.

Evaluation every year

“The basis of the study is the scientific data collected by our team on 22,324 Treviso athletes between the ages of 7 and 18, who have undergone 65,397 medical evaluations over the years – explains Sarto -. Our screening method differs from that proposed in other countries such as the United Kingdom, where young footballers undergo a single cardiovascular assessment at the age of 16: our athletes are taken into care at a very young age and repeat the assessment every year. very early identification of cardiovascular diseases at risk of sudden death during sporting activity and, when the first evaluation is unable to highlight the pathology, subsequent checks are essential.

In particular, the screening identified pathologies of the muscle and of the electrical system of the heart, serious ventricular arrhythmic forms and congenital heart disease in subjects at risk of “sudden death”.

69 young athletes saved

A very important fact that emerged from the study is that as many as 74% of cardiovascular diseases presenting this risk were diagnosed in children and young people under the age of 16: thanks to the “Italian” screening model, the lives of 69 were potentially saved young athletes. Out of 22,324 athletes evaluated, only one suffered from cardiac arrest during sporting activity, and survived thanks to cardiopulmonary resuscitation with the use of the defibrillator. “This is a very complex case because despite the many tests performed it has not yet been possible to identify the cause of the cardiac arrest” says Sarto.

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“Another added value of the activity carried out at the Centro della Marca, also reported in the study, is that after the diagnosis, young sportsmen with heart disease for several years are not “abandoned” but thanks to the program “Julian Ross’s second half” , the athletes continue to be followed by the team of specialists, which offers them the opportunity to have all the information necessary to safely continue the physical-sport activity most suitable for their new clinical condition” concludes Sarto.

The importance of the stress test

One fact that emerges from the study – adds Zorzi – is the fundamental role of the stress test in the medical-sports evaluation. In Italy, the stress test is always performed during the medical-sports visit, while abroad it is usually done at rest ECG. Our study demonstrates that the stress test, particularly for the evaluation of arrhythmias, made it possible to suspect cardiac pathology in several young sportsmen with a normal base ECG and who would otherwise have escaped it”. Zorzi concludes: “This data further underlines how the Italian screening model is second to none”

Veneto: less than 90% incidence of sudden death

“In 2006 a study of which I am the first author was published by the University of Padua in the prestigious journal Jama, which demonstrated how in the Veneto region the incidence of sudden athlete death has dropped by almost 90% following the introduction of sports medical screening – says Corrado -. That study had a very significant impact on an international level, contributing to exporting the Italian model of prevention of sudden death in the athlete abroad. However, some points remained to be clarified, which were promptly raised in the debates between experts, such as the usefulness of periodically repeating the screening. This study helps to clarify these aspects. We are confident that the results of this work will help change the role of sports medical screening internationally.”