Sudden Deaths In Young Ahtletes
Sudden deaths in young athletes
Today, most young people are conscious of the benefits of doing sport, therefore a considerable number practise sport regularly. The elite athletes who train for competitions are often seen as the healthiest group in society. However, sometimes the events are unpredictable and some athletes die during exercise. Even so, the actual rate of sudden death in young athletes is low, analysis estimates the prevalence in athletes to be less than one in 100,000 participants per year (Corrado, 2005). There is not a large quantity of deaths among athletes but when it occurs it is highly publicised. No-one expects healthy young people to die and it is a powerful and tragic event. Menander (4th century, BC) tries to alleviate the circumstances: “Those whom the gods love die young” (Allison, 2007). Firstly, this essay will introduce and indentify briefly the effects of regular exercise on the risk of disease. Secondly it will give some examples of deaths among athletes. Finally, there is an explanation of the main causes of these deaths and a conclusion in which some recommendations will be given to avoid future unexpected deaths.
Society is becoming very conscious of the need to exercise and its health benefits. More and more people do sport regularly and the ideal person is a sporty person with a trained body. Nowadays citizens need to do some kind of sport because most people have a sedentary job and so there is the need to increase the quantity of physical exercise. This is only a basic and small reason whereas there are some health benefits of doing exercise as described later. To begin with, there is a lower mortality rate for both older and younger adults who do sport regularly and a longer life is the most appreciate by humans. Regular exercise decreases the risk of cardiovascular disease, may lower the risk of noninsulin-dependent diabetes, may favourably affect the distribution of body fat, may decrease the risk of colon cancer and generally may enhance psychological well-being (Berning, 2005). It also reduces the risk of atherosclerosis and subsequent sudden cardiac death (Sarma, 2007). In this regard, Sarma (2007) suggests that athletes are perceived as the epitome of health, owing to their unique lifestyle and extraordinary physical achievements, however a small, but notable proportion of athletes die suddenly. In other words, regular sport has a significant number of benefits, although in some cases, sports people can be damaged seriously.
There are some appalling examples throughout the history of sudden deaths in young athletes. Corrado and Basso (2005, p 48) examined different cases since the Greeks:
• Pheidippides (490 BC): A Greek soldier and conditioned runner, Pheidippides ran from Marathon to Athens to announce military victory over Persia. He delivered his message, then collapsed and died.
• Daniel Yorath (1992): A 15-year-old football player who had just been signed by the UK team Leeds United, Daniel Yorath died from hypertropic cardiomyopathy while playing football with his father in the garden.
• Sergei Grinkov (1995): An Olympic gold medal skater, Sergei Grinkov collapsed and died from a heart attack at the age of 28 while training at an ice rink in Lake Placid, NY, USA. An autopsy showed that he had the arteries of a 70-year-old man.
As Ross and Jonathan (2007) stated, only during the year 2007 there were some different sudden deaths:
• The collapse of former marathon great Alberto Salazar during a training run, with what was later confirmed as a heart attack brought on by coronary artery disease.
• The death of two runners during the Comrades Ultramarathon in South Africa, from cardiac arrest.
• The collapse and death of a 22-year old professional soccer player in Spain, Antonio Puerta, during a televised match in the Spanish Premier League.
• The death of a 35-year old policeman, Chad Schieber, during the Chicago Marathon.
• The death of an elite level marathon runner, Ryan Shay, in the US Olympic Trial marathon.
• The Scottish footballer Phill O’Donnell died after collapsing during a game in which his team Motherwell F.C., of which he was captain, were playing a Scottish Premier League match.
Consequently there are many cases of sudden death. The main point to think about is the causes of these deaths. Surely there are some medical or natural causes, however the lack of prevention by analysis and tests before the competition is the main and most important cause.
There are many causes of sudden death in young athletes, though some of them do not have an identifiable cause. ‘Most young athletes who die suddenly have undiagnosed structural heart diseases’ (Corrado & Basso, 2005, p48). Nonetheless most of the sudden cardiac deaths can be explained medically. The most common cause of deaths is due to inherited cardiomyopathies, HCM (notably hypertrophic cardiomyopathy) and ARVC (arrhythmogenic right ventricular cardiomyopathy) (Sharma, 2007). HCM is the most common explanation for up to one third of all deaths. “Coronary artery anomalies are relatively common and usually benign” (Sharma, 2007, p288). It is noteworthy, however, that sudden death during sport is often the manifestation of cardiovascular disease. “Most young athletes who die suddenly show neither a positive family history nor pre-existent cardiovascular symptoms” (Corrado & Basso, 2005, p48). Sudden death in athletes may also occur from acquired causes, such as myocarditis, commotio cordis, drug misuse or trauma. As said in the introduction, the actual rate of sudden deaths is low, 1 in 100 000 athletes per year (Corrado, 2005). Therefore the problem is alarming for several reasons. First of all, there is no national registry for sudden death in sports, and data are derived from high-profile events or deaths of prolific athletes. Secondly, postmorten examinations on athletes are rarely made by an expert cardiac pathologist and the main causes, such as ARVC or HCM, may not be identified. Indeed there are some genetic and some acquired causes of sudden death in athletes, likewise data of deaths is not reliable and there must be a substantial number of deaths which are not included in statistics.
In summary, the sudden and unexpected death of a young athlete is a devastating tragedy. Regular sport practice is healthy and is needed by most of society. On the other hand some athletes have died during an intense sport activity, caused by several reasons. Every effort should be made to increase awareness of the cardiovascular risk associated with sport, and to implement comprehensive screening strategies to eliminate those risks. The percentage of people who die during a sport activity is very low, compared with the benefits of this activity. According to what is being said there are two main causes of sudden death in young athtletes who are apparently healthy. Inherited cardiomyopathies, such as HCM and ARVC, are the most common reason of sudden death. Likewise, there are other causes that can be acquired such as myocarditis, commotio cordis, drug misuse or trauma. Therefore, the media spread the events and confer them more magnitude than they have, but still it is impossible to know the real statistics of sudden deaths.
• Basso, C., Maron, B.J., Corrado, D. & Gaetano, T. (2000) ‘Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes’. Journal of The American College of Cardiology 35, pp. 1493-1501.
• Berning, R.J. (2005) Nutrition for sport and exercise. 2nd ed. Colorado: Aspen Publishers.
• Corrado, D. & Basso, C. (2005) ‘Sudden death in young athletes’. The Lancet 366 (1), pp. S47-S48.
• Maron, B.J. (2003) ‘Sudden death in young athletes’. N Engl J Med 349, pp. 1064–1075.
• Ross & Jonathan (2007) ‘Sudden death during exercise: What does it mean for you?’ The Science of Sport. Retrieved on 1 March 2008 from: http://scienceofsport.blogspot.com/2007/11/sudden-death-during-exercise-what-does.html
• Sharma, S. (2007) ‘Sudden cardiac death in young athletes’. Heart 93, pp. 287-289.