Etiology

Sudden death in young athletes is usually associated with physical exertion, and unsuspected congenital cardiac abnormalities are usually found postmortem in young athletes. For the purposes of this chapter, we limit our discussion of SCD to the younger athlete (those younger than 35 years of age), since in the older athlete, this issue is relatively straightforward; the overwhelming majority of sudden deaths are caused by atherosclerotic coronary artery disease.

The etiology of SCD in young athletes has been well documented. Maron et al1 analyzed 158 sudden deaths in athletes in the United States from 1985 to 1995. Eighty-five percent of deaths were cardiovascular in nature, and hypertrophic car-diomyopathy (HCM) and congenital coronary artery abnormalities were the most common causes of sudden death. Basketball and football players accounted for 68% of deaths, this in large part due to the greater number of athletes participating in these two sports at all levels. The common causes of SCD in young athletes are listed in Table 4-1.

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