Sudden cardiac death in young athletes: a review

Article Abstract:

The causes of sudden unexpected death (SUD) from cardiac causes in young athletes are reviewed, with additional information concerning preventive measures that could be taken. SUD among this group is rare, occurring once or twice per 200,000 athletes each year; however, public concern about it is great. The leading cause of SUD in young athletes is hypertrophic cardiomyopathy (HCM), a condition known by many names, but in which the heart's left ventricle (the muscular chamber that pumps blood to the body) becomes enlarged. The increased muscle thickness associated with HCM reduces the size of the chamber and the volume of blood that can fill it. The ultimate result is a disturbance of cardiac rhythm, with death usually due to ventricular fibrillation (rapid, ineffectual contraction of the ventricle). Other conditions associated with SUD include abnormalities of the coronary arteries (which supply the heart muscle with blood); atherosclerotic coronary artery disease (formation of fatty plaque within the arteries); acute myocarditis (inflammation of the heart muscle); Marfan syndrome (a genetic disease of connective tissue); mitral valve prolapse (''floppiness'' of the valve between the left ventricle and atrium); and primary disorders of heart rhythm (dysrhythmias). Children with aortic stenosis (narrowing of the aorta, the vessel that carries blood from the heart to the body, at its base) should be examined by a pediatric cardiologist. If the condition is severe, they should not participate in sports. Only one fourth of the athletes who suffer sudden cardiac death have symptoms that suggest a heart abnormality, and some researchers believe correct diagnosis of these conditions in athletes is unlikely. The authors of the current report disagree, and support competent screening examinations for young people. A description is presented of the ideal screening evaluation. It should evaluate the athlete's history and physical condition. If a potentially life-threatening defect is found, the athlete, his or her family, and the team must work to adjust to the situation. In most cases, careful examination can identify athletes at risk for SUD. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Patient outcomes, Mortality, Causes of, Heart diseases, Sudden death, Athletes

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Family history fails to identify many children with severe hypercholesterolemia

Article Abstract:

The best method of screening children for elevated cholesterol has not been established. Current recommendations are to screen children who have a family history of either elevated blood lipid (fat) levels or early onset of coronary heart disease. It has been suggested that this method of screening may miss many children with hypercholesterolemia (elevated cholesterol levels in the blood). A study was undertaken to determine if detailed family histories would have identified children later known to have moderate or severe hypercholesterolemia. A group of 114 children was studied. The age range of the children was 2 to 18 (average age 8.2 years) and 73 percent of the children were white. Most children came from upper-middle-class families. The guidelines of the American Academy of Pediatrics were used to define a positive family history. It was found that of children having total cholesterol levels greater than the 75th percentile, 22 percent did not have family histories for either hypercholesterolemia or premature coronary heart disease. Of children whose levels were greater than 95th percentile, 18.3 percent had negative histories. Seventy-eight children had both hypercholesterolemia and positive family history; 72 families reported hyperlipidemia and 27 premature coronary heart disease. These results suggest that a detailed family history fails to identify many children with hypercholesterolemia, as well as a high proportion of children with elevated cholesterol. Children who have hypercholesterolemia more often have family histories of hyperlipidemia rather than of early coronary heart disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Evaluation, Diagnosis, Medical screening, Health screening, Genealogy, Hypercholesterolemia in children, Pediatric hypercholesterolemia

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