# Exercise as it relates to Disease/What is the risk of sudden cardiac death in American college athletes?

Sudden cardiac death describes the unexpected natural death from a cardiac cause within a short time period, generally ≤1 hour from the onset of symptoms, in a person without any prior condition that would appear fatal (1) . Over the years there have been few studies completed as it is proven difficult to identify cases of sudden cardiac death. As there are no real warning signs athletes are unaware of the possibility of this occurring. The true incidence of sudden cardiac death (SCD) in US athletes is unknown. Current estimates are based largely on case identification through public media reports and estimated participation rates (2) .
It is documented that the leading medical cause of death was SCD (45 of 273 deaths, or 16%), and this cause was responsible for roughly the same amount of deaths as homicide and suicide combined, Therefore, Cardiac deaths accounted for the majority of medical deaths (45 or 56%). The incidence of SCD in an NCAA student-athlete was 1:43 770 per year (2).
The true incidence of cardiac death is unknown (2) with most studies making estimated guesses through the use of media articles and estimated participation rates. The article “Incidence of Sudden Cardiac Death in National Collegiate Athletic Association Athletes” was created to attempt to get a more precise number of sudden cardiac deaths and test the accuracy of traditional methods for the collection of data for sudden cardiac death.

## The Research
#### Where it was conducted

This article was published by the American Heart Association and was conducted at the university of Washington in Seattle USA.

#### The type of research

The research that was conducted for this article was confirmatory quantitative, the conductors of the research investigated the records that were submitted to a database by the NCAA.

#### How it was conducted

The true incidence of SCD in athletes is widely debated and largely unknown in the United States (2). Over a 5-year period (January 2004 to December 2008) all cases of sudden cardiac death in National Collegiate Athletic Association (NCAA) student athletes where identified by the use of a database, weekly systematic search of public media reports and catastrophic insurance claims. The NCAA can at any time consist of 40,000 students from the age 17 to 23 years old participating in as many as 40 different sports (2).

## Results
### Overview

Over the 5-year period there were 273 deaths with 45 (56%) of these being from cardiovascular related sudden death, this means that sudden cardiac death was the highest cause of death over the 5 years. Of the 45 cardiac cases only 39 cases were reported in the NCAA database. The article separated the results into a number of different categories.
* Ethnicity
* Gender
* Age
* Division of play(1,2 and 3)
Risk varied considerably by sport with Basketball being by far the highest-risk sport out of the 40 sports, with an overall of 14 deaths occurring over the five-year period. Males had 34 cardiac deaths where females had 11 and the athletes competing in division 1 had more deaths with 27 than 2 and 3 combined which had 18. As for the ethnicity case there were 44 cases where they were identified as black or white other ethnicities where not clear therefore the ethnicity was not used in calculations. There were 36 medical cases that were identified as occurring at exertion, others occurred at rest or could not be classified. Of the 36 exertion cases 27 were proven to be from a cardiac causes including stroke.

### Interpretation of results

The study had shown that the incidence and risk of sudden cardiac death is far more higher than first thought, with this study showing that 1:43,000 athletes are at risk of sudden cardiac death where previous studies had reported varying results from 1:23,000 to 1:300,000 are at risk. This study was far more reliable as other studied didn't go into as much depth with their methods as this one has. From the results this study found they have suggested that the use of an ECG test which have proven to detect 66%-100% of silent cardiac diseases in athletes. With using ECG it will reduce the risk of SCD in athletes at college

## Conclusion and Implications

This Article had definitely furthered the research into sudden cardiac death in young athletes, if it was to go a step further in the research it could have all the athletes (American college students) tested for any cardiac illnesses. In doing this it would understandably be very expensive and quite a difficult area to look into as in some cases of SCD there is no real explanation of why the athlete passed away without warning.
From the investigation into sudden Cardiac Death in college athletes it is clear that SCD is a very serious issue that is often underestimated and underreported. As stated in the article it is one of the leading cause of death in American college athletes. This information implies that there is more need for SCD to be brought to peoples attention mainly coaching staff and athletes so it can be managed for example having athletes tested for underlying cardiac conditions because from other reports quite a number of deaths from SCD could have been prevented if the athlete was tested and the health condition was identified.

## References

{{1-http://circ.ahajournals.org/content/98/21/2334.full, Douglas P. Zipes, MD; Hein J. J. Wellens, MD
2-http://circ.ahajournals.org/content/123/15/1594.full, Kimberly G. Harmon, MD; Irfan M. Asif, MD; David Klossner, ATC, PhD; Jonathan A. Drezner, MD}}