Published Online
on February 16, 2009

A more recent version of this article appeared on March 3, 2009

This Article Full Text (PDF) CME: Take the course for this article: Circulation: March 3, 2009, Volume 119, Number 8 All Versions of this Article: 119/8/1085    most recent CIRCULATIONAHA.108.804617v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Maron, B. J. Articles by Mueller, F. O. Search for Related Content PubMed PubMed Citation Articles by Maron, B. J. Articles by Mueller, F. O. Related Collections Hypertrophy Myocardial cardiomyopathy disease Exercise/exercise testing/rehabilitation Epidemiology Related Article

Submitted on July 8, 2008
Accepted on December 15, 2008

Sudden Deaths in Young Competitive Athletes. Analysis of 1866 Deaths in the United States, 1980–2006

Barry J. Maron MD^*, Joseph J. Doerer BS, Tammy S. Haas RN, David M. Tierney MD, and Frederick O. Mueller PhD

From the Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation and Abbott Northwestern Hospital, Minneapolis, Minn (B.J.M., J.J.D., T.S.H., D.M.T.), and the National Center for Catastrophic Sports Injury Research and the University of North Carolina, Chapel Hill, NC (F.O.M.).

^* To whom correspondence should be addressed. E-mail: hcm.maron{at}mhif.org.

Background—Sudden deaths in young competitive athletes are highly visible events with substantial impact on the physician and lay communities. However, the magnitude of this public health issue has become a source of controversy.

Methods and Results—To estimate the absolute number of sudden deaths in US competitive athletes, we have assembled a large registry over a 27-year period using systematic identification and tracking strategies. A total of 1866 athletes who died suddenly (or survived cardiac arrest), 19±6 years of age, were identified throughout the United States from 1980 to 2006 in 38 diverse sports. Reports were less common during 1980 to 1993 (576 [31%]) than during 1994 to 2006 (1290 [69%], P<0.001) and increased at a rate of 6% per year. Sudden deaths were predominantly due to cardiovascular disease (1049 [56%]), but causes also included blunt trauma that caused structural damage (416 [22%]), commotio cordis (65 [3%]), and heat stroke (46 [2%]). Among the 1049 cardiovascular deaths, the highest number of events in a single year was 76 (2005 and 2006), with an average of 66 deaths per year (range 50 to 76) over the last 6 years; 29% occurred in blacks, 54% in high school students, and 82% with physical exertion during competition/training, whereas only 11% occurred in females (although this increased with time; P=0.023). The most common cardiovascular causes were hypertrophic cardiomyopathy (36%) and congenital coronary artery anomalies (17%).

Conclusions—In this national registry, the absolute number of cardiovascular sudden deaths in young US athletes was somewhat higher than previous estimates but relatively low nevertheless, with a rate of <100 per year. These data are relevant to the current debate surrounding preparticipation screening programs with ECGs and also suggest the need for systematic and mandatory reporting of athlete sudden deaths to a national registry.

Key words: cardiomyopathy • death, sudden • cardiovascular diseases

Related Article:

Clinical Summaries
Circulation 2009 119: 1067-1068. [Extract] [Full Text]

This article has been cited by other articles:

				S. Gupta, T. Baman, and S. M. Day Cardiovascular Health, Part 1: Preparticipation Cardiovascular Screening Sports Health: A Multidisciplinary Approach, November 1, 2009; 1(6): 500 - 507. [Abstract] [Full Text] [PDF]

				D. Corrado, C. Basso, and G. Thiene Letter by Corrado et al Regarding Article, "Sudden Deaths in Young Competitive Athletes: Analysis of 1866 Deaths in the United States, 1980-2006" Circulation, October 20, 2009; 120(16): e143 - e143. [Full Text] [PDF]

				B. J. Maron, J. J. Doerer, T. S. Haas, D. M. Tierney, and F. O. Mueller Response to Letter Regarding Article, "Sudden Deaths in Young Competitive Athletes: Analysis of 1866 Deaths in the United States, 1980-2006" Circulation, October 20, 2009; 120(16): e144 - e144. [Full Text] [PDF]

				J. Drezner, B. Pluim, and L. Engebretsen Prevention of sudden cardiac death in athletes: new data and modern perspectives confront challenges in the 21st century Br. J. Sports Med., September 1, 2009; 43(9): 625 - 626. [Full Text] [PDF]

				N M Panhuyzen-Goedkoop Preparticipation cardiovascular screening in young athletes Br. J. Sports Med., September 1, 2009; 43(9): 629 - 630. [Full Text] [PDF]

				B J Maron Distinguishing hypertrophic cardiomyopathy from athlete's heart physiological remodelling: clinical significance, diagnostic strategies and implications for preparticipation screening Br. J. Sports Med., September 1, 2009; 43(9): 649 - 656. [Abstract] [Full Text] [PDF]

				B R Anderson and V L Vetter Return to play? Practical considerations for young athletes with cardiovascular disease Br. J. Sports Med., September 1, 2009; 43(9): 690 - 695. [Abstract] [Full Text] [PDF]

				J A Drezner Preparing for sudden cardiac arrest--the essential role of automated external defibrillators in athletic medicine: a critical review Br. J. Sports Med., September 1, 2009; 43(9): 702 - 707. [Abstract] [Full Text] [PDF]

				S V de Noronha, S Sharma, M Papadakis, S Desai, G Whyte, and M N Sheppard Aetiology of sudden cardiac death in athletes in the United Kingdom: a pathological study Heart, September 1, 2009; 95(17): 1409 - 1414. [Abstract] [Full Text] [PDF]

				B. J. Maron, J. J. Doerer, T. S. Haas, N.A. M. Estes, J. S. Hodges, and M. S. Link Commotio Cordis and the Epidemiology of Sudden Death in Competitive Lacrosse Pediatrics, September 1, 2009; 124(3): 966 - 971. [Abstract] [Full Text] [PDF]

				J. A. Drezner, A. L. Rao, J. Heistand, M. K. Bloomingdale, and K. G. Harmon Effectiveness of Emergency Response Planning for Sudden Cardiac Arrest in United States High Schools With Automated External Defibrillators Circulation, August 11, 2009; 120(6): 518 - 525. [Abstract] [Full Text] [PDF]

				D. L. Atkins Public Access Defibrillation: Where Does It Work? Circulation, August 11, 2009; 120(6): 461 - 463. [Full Text] [PDF]

				B. J. Maron, D. Zipes, and A. Pelliccia Reply J. Am. Coll. Cardiol., June 16, 2009; 53(24): 2311 - 2311. [Full Text] [PDF]

				L. T. Cooper Jr. Myocarditis N. Engl. J. Med., April 9, 2009; 360(15): 1526 - 1538. [Full Text] [PDF]

				P. D. Thompson Preparticipation Screening of Competitive Athletes: Seeking Simple Solutions to a Complex Problem Circulation, March 3, 2009; 119(8): 1072 - 1074. [Full Text] [PDF]