[II-JCKAP2-7] Sudden Cardiac Death in Athletes
キーワード：Sudden cardiac death, channelopathy, cardiomyopathy
Sudden cardiac death (SCD) in athletes is a rare but devasting event, affecting the family and others, and has societal and emotional implications. Research into this requires good data collection, accurate documentation, and post-mortem studies with recent publications shedding some light on this. A diverse spectrum of cardiac disorders can cause SCD, including congenital abnormalities (AAOCA anomalous aortic origin of coronary arteries), cardiomyopathies, electrical cardiac disturbances (channelopathies leading to rhythm disorders). Those who died at rest were more likely to have a normal heart. Conversely, those who died during exercise were more likely to have arrhythmogenic CMP, HCM, LV fibrosis, coronary artery abnormalities and commotio cordis. There is also considerable discussion on what may be required in pre-participation screening, which takes into consideration risks and costs. Clearly, a good history, including a family history, and physical examination are important. Many would include an ECG in the assessment. ECG screening may be useful for cardiomyopathies, channelopathies and less useful for coronary anomalies. The value of further screening test such as echocardiography is controversial. Insight into this condition can better guide us in formulating public health policies such as screening, detection and education. Availability of help in the chain of survival (cardiopulmonary resuscitation and AED) can also make a significant difference in achieving better outcomes for our patients.