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Sudden cardiac death in athletes
  1. Christopher Semsarian1,2,3,
  2. Joanna Sweeting1,2,
  3. Michael J Ackerman4
  1. 1Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Newtown, NSW, 2042, Australia;
  2. 2Sydney Medical School, University of Sydney, Sydney, NSW, Australia;
  3. 3Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia;
  4. 4Departments of Medicine, Pediatrics, and Molecular Pharmacologyand Experimental Therapeutics, Divisions of Cardiovascular Diseases and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, USA
  1. Correspondence to C Semsarian, c.semsarian{at}

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Sudden cardiac death is defined as an unexpected death, occurring usually within one hour from onset of symptoms in cases where the death is witnessed and in un witnessed cases within 24 hours of the individual last being seen alive and well.1 Sudden cardiac death in athletes is the leading cause of medical death in this subgroup, with an estimated incidence of 1 in 500 to 1 in 80 000 athletes per year, although a wide range has been reported, from 1 in 3000 in some subpopulations to 1 in 1 00 0000.2 Males, black or African Americans, and basketball players seem to be at a higher risk than other subgroups.2

Although rare, sudden cardiac death in athletes is important because of its impact within both the sporting community and the general community. The widely held perception is that athletes represent examples of health and vitality, so the sudden cardiac death of an athlete can evoke strong emotions and disbelief. The esteem in which athletes are held, in combination with often highly emotive reporting from the media, means that these events are tragedies not only on a personal family level but also at a public level.3 This review summarises the common causes of sudden cardiac death in athletes and examines whether systematic training can confer increased risk for the condition. Also considered are the measures that can be undertaken to prevent sudden cardiac death.

What is an athlete?

A competitive athlete is defined as “one who participates in an organised team or individual sport that requires regular competition against others as a central component, places a high premium on excellence and achievement, and requires some form of systematic (and usually intense) training.”4 Although this generally includes students in high school, college, and university and those participating in paid professional …

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  • Contributors: CS and JS planned the outline of the review, wrote the manuscript, and edited subsequent drafts. MJA assisted in writing the manuscript and edited subsequent drafts.

  • Competing interests: We have read and understood the BMJ policy on declaration of interests and declare: CS is the recipient of a NHMRC practitioner fellowship (No 571084). JS is the recipient ofthe Elizabeth and Henry Hamilton-Browne scholarship from the University of Sydney. MJA is supported by the Mayo Clinic Windland Smith Rice comprehensive sudden cardiac death programme.

  • Provenance and peer review: Commissioned; not externally peer reviewed.