Author + information
- Received August 12, 2014
- Revision received October 9, 2014
- Accepted October 21, 2014
- Published online February 10, 2015.
- ∗The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
- †Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- ↵∗Reprint requests and correspondence:
Dr. Sumeet S. Chugh, Cedars-Sinai Medical Center, Advanced Health Sciences Pavilion, Suite A3100, 127 South Vicente Boulevard, Los Angeles, California 90048.
The overwhelming majority of sports-related sudden deaths occur among those older than 35 years of age. Because increasing numbers of older people are participating in organized endurance and competitive sporting events, the incidence of sports-related sudden death in older adults is expected to rise. Older athletes will approach clinical cardiologists for advice regarding their fitness for participation. It is important to recognize both that strenuous exercise is associated with a transient elevation in risk of sudden cardiac death and that appropriate training substantially reduces this risk. The approach to pre-participation screening for risk of sudden death in the older athlete is a complex issue and at present is largely focused on identifying inducible ischemia due to significant coronary disease. In this brief review, we summarize the current state of knowledge in this area with respect to epidemiology, mechanisms, and approaches to risk stratification, as viewed from the perspective of the consulting clinical cardiologist.
Both authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 12, 2014.
- Revision received October 9, 2014.
- Accepted October 21, 2014.
- American College of Cardiology Foundation
- Current Burden and Future Projections
- Evidence for Transient Elevation in Risk With Exercise, Countered by a Protective Effect of Regular Exercise
- Potential Mechanisms of Exercise-Induced SCD
- Potential Hazards at the High End of the Exercise Spectrum
- Clinical Approach to Risk Stratification for SCD in Older Athletes: Greatest Utility in the Sport-Naïve Athlete
- Authors’ Recommendations for Risk Stratification in the Asymptomatic Patient
- Pre-participation Screening in the Older Athlete: Future Considerations
- Strategies to Mitigate Risk in the Sport-Naïve Athlete: Authors’ Suggestions