Abstract 19861: Incidence and Etiology of Sudden Cardiac Arrest and Death in US High School Athletes
Background: The precise incidence and etiology of SCA/SCD in US athletes is unknown due to the absence of mandatory reporting. Search of public media reports captures 20% - 50% of SCD events in high profile athletes, therefore, incidence rates relying on media reports are underestimates.
Objective: To investigate the incidence and etiology of SCA/SCD in a large population of US high school athletes.
Methods: A database of SCA/SCD in the young established by prospective and systematic search of media reports was queried for cases aged 14 - 18 from 7 states over 6 school years (2007 - 2013). Details of SCA/SCD events were investigated to determine participation on a high school athletic team, sex, sport, and occurrence during school-sponsored activity or with exertion. Cases in non-athletes, without sufficient information, or non-cardiac in origin were excluded. Sport participation numbers from the National Federation of State High School Associations (NFHS) were used and a conversion factor applied to account for athletes playing more than one sport. Autopsy reports were requested and cause of death adjudicated by an expert panel using standard definitions.
Results: A total of 16,390,409 million athlete-seasons were examined representing 36% of the total US high school athlete population. 104 cases of SCD/SCA were examined (69 deaths, 35 arrests with survival). The rate of SCD was 1:101,082 and for all SCA/SCD 1:67,064. 88% of events occurred in males. The rate of SCA/SCD in males was 1:44,832 and in females was 1:237,510 (RR 5.3, p<0.00001). 87% of events were exertional and 63% occurred while playing for a school sponsored team. 75% of autopsy reports were obtained. The most common findings on autopsy were idiopathic left ventricular hypertrophy/possible cardiomyopathy (13, 26%), autopsy-negative sudden unexplained death (9, 18%), hypertrophic cardiomyopathy (7, 14%), and myocarditis (7, 14%).
Conclusions: The rate of SCA/SCD in high school athletes is higher than prior estimates. It is likely many cases were not identified due to reliance on media reports and thus these numbers represent a minimum estimate. Further evaluation with mandatory reporting and autopsies performed at specialized centers are needed to better understand SCA/SCD in this population.
- Sudden cardiac death
- Sudden death
- Automated external defibrillator (AED)
- Hypertrophic cardiomyopathy
- Risk factors
Author Disclosures: K.G. Harmon: Research Grant; Significant; Sonosite. I.M. Asif: None. J. Maleszewski: None. D.S. Owens: None. J. Prutkin: None. J. Salerno: None. R. Ellenbogen: None. M. Zigman: None. M. Ackerman: Consultant/Advisory Board; Modest; Boston Scientific, Gilead Sciences, Medtronic, St. Jude Medical. Other; Significant; Transgenomic (Royalties). J.A. Drezner: Research Grant; Significant; Sonosite.
- © 2014 by American Heart Association, Inc.