Cardiovascular safety in sport: the issue of prevention

Sudden cardiac death (SCD) in the young athlete, apparently healthy, agonists or not, is the result of an unexpected cardiac malfunction. Physical activity causes an adaptation of the cardiovascular systems but does not increase the risk of SCD in healthy subjects. However, in the presence of underlying cardiovascular diseases, it may trigger a malignant cardiac event causing SCD. The most common diseases that may cause SCD are hypertrophic cardiomyopathy, cardiac electrical abnormalities, and congenital coronary anomalies. Only electrical abnormalities can easily be identified with the popular electrocardiographic testing. The other diseases may require echocardiographic testing which, however, is not included in the standard screening programs for athletes.