Sudden cardiac death in regularly training young athletes: risk factors and prevention

Abstract

Sudden cardiac death (SCD) in young athletes engaged in regular intensive training represents a rare but highly significant clinical and social problem. Although the incidence is low, SCD typically occurs unexpectedly during physical exertion or shortly thereafter, often as the first manifestation of previously undiagnosed cardiovascular disease. The main etiological factors include hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, myocarditis, dilated cardiomyopathy, and primary electrical disorders such as long QT syndrome. Risk stratification is based on a comprehensive approach that involves clinical history, physical examination, resting and exercise electrocardiography (ECG), echocardiography, and, in selected cases, genetic testing. Recent consensus statements highlight the importance of improving ECG interpretation criteria to reduce false-positive results in athletes. Preventive strategies include pre-participation cardiovascular screening, continuous follow-up of high-risk groups, and timely intervention in suspected cases. Equally important are emergency measures, including cardiopulmonary resuscitation and rapid use of automated external defibrillators, which significantly improve survival outcomes. Awareness of potential risk factors, combined with optimized screening protocols and personalized decision-making, may reduce the incidence of SCD in the athletic population.