April 4, 2011 -- The sudden cardiac death rate for collegiate athletes is higher than many previous estimates and could influence screening guidelines for youths participating in organized sports, a new study suggests.
Each year, about one in 44,000 players in the National Collegiate Athletic Association has sudden cardiac death, the report says.
Study author Kimberly Harmon, MD, of the University of Washington in Seattle, says previous estimates of such deaths often have been based on inconsistent data sources, including media reports.
Tracking Deaths of Young Athletes
In the new study, data from the NCAA was used, along with news reports and insurance claims. It says about 400,000 students between age 17 and 23 participate in NCAA sports every year.
Harmon and her research team tracked deaths from 2004-2008, and report that:
- The total number of deaths from all causes was 273.
- 68% of deaths, or the deaths of 187 athletes, were due to non-medical or traumatic causes.
- 29%, or 80 athletes, died from medical causes.
- 2%, or six young people, died from unknown causes.
The study says the deaths of 45 young athletes, or 56% of deaths from medical causes, were cardiovascular-related sudden deaths.
Of 36 deaths that occurred during or shortly after exertion, 75% were due to cardiac causes.
In total, the researchers say one in 43,770 athletes died annually of sudden cardiac death.
Potential Guideline Changes
American Heart Association (AHA) president Ralph L. Sacco, MD, MS, tells WebMD the study is important and could lead to changes in the organization’s current guidelines for screenings of athletes.
“This new report provides some new valid information that we have not had in the past that provides fairly excellent statistics regarding sudden cardiac death in certain athletes,” he tells WebMD. “We haven’t had this kind of complete information in the past.”
Sacco says the AHA has always recommended physical exams and personal histories of athletes, but not costly procedures such as electrocardiograms, called EKGs, or echocardiograms, which are basically ultrasound tests of the heart.
But he says Harmon’s findings may make the AHA rethink its guidelines and possibly recommend EKGs.
“This new information will be taken into consideration as to whether it’s enough to make any changes,” Sacco says.
Focus on Heart Issues
When young athletes die of sudden cardiac death, interest increases, Sacco says.
For example, the sudden death earlier this year of Fennville, Mich., high school basketball star Wes Leonard, 16, who collapsed and died just minutes after scoring a winning basket, received widespread publicity. An autopsy said he died of dilated cardiomyopathy, more commonly referred to as an “enlarged heart.”
The AHA says in policy guidelines that athletic training and competition can increase the risk of sudden cardiac death in people with underlying heart disease.
In a news release, the AHA says various heart conditions can be deadly for young athletes, and the most common is hypertrophic cardiomyopathy, an abnormal growth of heart muscle fibers.
Other Study Findings
Other key findings of the study included:
- African-American athletes had a sudden cardiac death rate of one in 17,696, compared with one in 58,653 for white competitors.
- The risk for males was one in 33,134 vs. one in 76,646 for females.
- The highest risk rate of sudden cardiac death was associated with playing basketball, with a rate of one in 11,394. Swimming was associated with the second-highest risk, followed by lacrosse, football, and cross-country track.
- The risk of sudden cardiac death in male athletes in Division I basketball was about one in 3,000.
The AHA in 2007 issued a statement recommending that every athlete give a detailed personal and family medical history and have a thorough physical exam before participating in sports. Further testing would then be warranted if such tests revealed worrisome data.
The European Society of Cardiology and the International Olympic Committee have recommended the addition of EKGs. But the AHA has so far considered that too costly and unwieldy for the large population of American athletes. More extensive testing may be practical if targeted at higher-risk groups, such as basketball players, Sacco says. In addition, automated external defibrillators, which are used to revive people whose hearts have stopped, could and should be placed in areas where the highest-risk sports are played, he tells WebMD.