Sudden Cardiac Death: Up to 80% of Athletes Who Die Suddenly Had No Symptoms
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New recommendations published in the European Journal of Pernovice Cardiology outlines how genetic testing should be used to prevent sudden cardiac death in athletes and enable safe exercise.
Recommendations on how to use gene testing to prevent sudden cardiac death in athletes and enable safe exercise were published in the European Journal of Preventive Cardiology, on June 16, 2022, the journal of the European Society of Cardiology (ESC).
“Genetic testing for potentially fatal different conditions is more accessible than ever and the document focuses on where athletes should be tested and when,” the doctor said. St. George’s Michael Papadakis, London University, United Kingdom. “Carpur people should be consulted on possible outcomes before genetic testing as it could mean excluded or restricted play”
In most cases, the clinical diagnosis will order the need for precautionary therapy such as a defibrillator and advice on exercise and participation in competitive sports. Doctor. Papadacis explained: “Even if a genetic asmanita is found, treatment recommendations and return to play usually depend on how medically severe the disease is.” Is it causing symptoms like fainting? Is the heart too weak or fat? Do we see many cardiovascular disorders (arrhythmia) and do they get worse during exercise?
If the answer to any of these questions is ‘yes’, then the game is likely to be off somehow
One example is a hereditary condition that can cause sudden cardiac death in athletes called hypertropical cardiomyopathy (HCM), where the heart muscle is abnormally obese. Doctor. Papadox noted: “We used to be very conservative but now our advice is more free thought.” Athletes with HCM should undergo a comprehensive medical diagnosis to assess the risk of sudden cardiac death and then be presented with an exercise prescription. Genetic testing in this case doesn’t affect administration in most cases. Asymptomatic athletes are considered at lower risk for possibly participating in competitive sports after having an informed conversation with their doctor. Other high-risk individuals can be restricted to moderate-intensity exercise. Exercise prescription should be as specific as possible and outline how often, for how long, at what intensity, and what exercise or sport is safe
However, in some cases, genetic testing can rule management.
One example is chronic QT syndrome (LQTS), which is a hereditary electrical fault of the heart. Identification of different genetic subtypes (LQT 1 – 3) can inform the risk of irithemias, identify potential triggers to avoid, and help to target medical treatment and plan exercise advice. Doctor. Papadakis said: “For example, LQT type due to sudden immersion in cold water – I have 2 or 3 instead of the deadly Eritemias Type 1, so one should be more careful of swimmers who have 1 genetic subtype than runners.” Is there anyone who wants to buy this
The only condition where genetic testing alone can be ruled out of sport is a cardiovascular condition known as erythemic cardiomyopathy (ARVC). “Even if an athlete has no medical evidence of the disease but has the gene for the condition, he should avoid high-intensity and competitive sports,” the doctor said. Papadacisses. “That’s because studies show that genes who exercise at a higher level promote the disease early in life and develop more severe illness that they can cause.” Life – Sports During threenging aritemia
Pre-test genetic consultations should be conducted to discuss the implications for athletes and their families.
For example, an athlete’s mother is medically diagnosed with ARVC and caused by a gene, the player is then screened and all clinical tests are followed as usual. The player has two choices: 1) Medical supervision, perhaps yearly, to test for symptoms of the disease. or 2) Genetic testing. “That player needs to know if the test is positive that could signal the end of his career, even if there is no medical proof of illness,” the doctor said. Papadacisses. On the other hand, if genetic testing is denied, things can get worse. Post-test counseling is important, especially if the player has been eliminated from the game, given the potential psychological, financial, and mental health implications.
For children’s athletes, genetic counseling at a pediatric mental health specialist may be required.
Doctor. Papadox noted: “The psychological impact of a positive genetic test result can be significant for a child, especially if it leads to sport withdrawal even in the absence of a clinical disease like ARVC.”
In children medically diagnosed with a hereditary condition, genetic testing can confirm the diagnosis and in some cases help predict the risk of sudden death during sports. For example, having a gene for a cardiac electrical fault that can lead to advice for prevention treatment from catecolaminergic polymorphic ventricular ventricular cardiovascular (CPVT), such as beta blockers, and order decisions about exercise.
“This is important because CPVT predicts arthritis during exercise and can cause sudden death at a very young age,” the doctor said. Papadacisses. In contrast, the timing of genetic testing in children with a family history of HCM is controversial because it causes sudden death in childhood in the absence of medical symptoms.
Reference: “Indications and Benefits of Cardiac Genetic Testing in Flour” Sylvia Castelletti, Belinda Gray, Christina Basso, Elias R. Deaf, Lea Crotti, Perry M. The Elite, Cecilia M. Gonzalez Corsica, Flavio De Scenzie, Jody Ingles, Bart Louise, Antonis Pantazis, Guido E. Palis, John Senin, Georgia Circilla Brogada, Maria Sanz de la Garza, Sanjay Sharma, Emilin M. Van Crane Brooke, Arthur Wilde and Michael Papadakis, 16 June 2022, European Journal of Preservative Cardiology.
The scientific statement was prepared by the Sports Cardiology and Exercise Section of the ESC Working Group on Myocardial and Pericardial Diseases, ESC Council for Cardiovascular Genomics, European Society Of Human Genetics and Association For European Pediatric and Obstetric Cardiology.