What is the chance of sudden cardiac death during exercise?

Exercise is good for your health, but it is not without risks! In high-intensity sports, athletes occasionally suffer sudden cardiac arrest, and even in the hospital emergency room, they receive people who come in for emergency treatment due to sudden death during exercise. So, what are the chances of sudden cardiac death during exercise? How to avoid it?

teenager

Among adolescents, the incidence of sudden cardiac death is 1/100,000 (people), which is approximately 0.001%/year. At this age, the most common causes of sudden cardiac death are:

1. Myocarditis

2. Cardiac hypertrophy

3. Long QT syndrome

4. Coronary artery abnormalities

5. Brugada syndrome etc.

Adults

When people get older, around 35 years old, the incidence of sudden cardiac death rises to 1/500~1000 (people), which is about 0.1~0.2%/year. In the middle-aged and elderly stage, that is, after the age of 50, if there is concurrent heart disease, the incidence of sudden death is higher, 1/4-5 (people), and the probability is about 10~25%/year. In the middle-aged and elderly stages, the most common causes of sudden cardiac death are as follows:

1. Coronary artery disease

2. Enlarged heart

3. Heart valve disease etc.

athlete

According to research by The National Collegiate Athletic Association (NCAA), the prevalence of sudden cardiac death varies with different types of sports. Among athletes, the top causes of sudden cardiac death are:

1. AN-SUD: autopsy-negative sudden unexplained death (31%)

2. CAD, coronary artery disease (14%)

3. Myocarditis related (8%)

4. DCM, dilated cardio-myopathy (8%)

5. Aortic dissection (8%)

6. HCM, hypertrophic cardiomyopathy (8%)

Note: The National Collegiate Athletic Association (NCAA) is a national amateur sports association composed of 1,281 sports associations or individuals in the United States and Canada. It is a non-profit organization headquartered in Indianapolis, Indiana.

Pre-exercise assessment

From adolescence, middle age, to old age, the probability of sudden death increases year by year as people age. It is conceivable that this is related to physical aging. If we add the variable of "exercise", the chance of sudden death is likely to increase even more!

Excluding sudden death of unknown causes, in order to avoid sudden cardiac death, a cardiac ultrasound can be arranged to rule out problems with the heart's anatomical structure, or an electrocardiogram can be arranged to see if there is any heart arrhythmia. There are many characteristics of an abnormal ECG, a few of which are listed below:

• T wave inversion

• ST segment depression

• Pathologic Q waves

• Complete LBBB

• QRS ≥ 140 ms duration

• Epsilon wave

• Ventricular pre-excitation

• Prolonged QT interval

• Brugada Type 1 pattern

• Profound sinus bradycardia < 30 bpm

• PR interval ≥ 400 ms

• Mobitz Type II 2 ̊ AV block

• 3 ̊ AV block

• ≥ 2 PVCs

• Atrial tachyarrhythmias

• Ventricular arrhythmias

If the above abnormalities are found in the electrocardiogram, it is recommended to be referred to a specialist for further detailed examination.

Summarize

It is not necessary for ordinary people to undergo a detailed heart examination before exercising. However, if you have heart disease or a family history of it (e.g., unexplained sudden death), or if you participate in high-intensity sports competitions, you may consider undergoing examination to rule out arrhythmia or problems with the heart's anatomy.

This article is from: Dr. Ye Junjuan's blog

※For more information, please visit Dr. Yeh Jun-kwan’s blog