Sudden cardiac death during sport: 5 possible causes at a glance

Sudden cardiac death  or cardiac arrest during sports can affect ambitious amateurs in particular. According to the German Sudden Cardiac Death Register, sudden cardiac death most often occurs during soccer and running.

Cardiac arrest or sudden cardiac death during sports do not occur without a reason: the heart is usually already damaged. This can lead to electrical instability of the heart and subsequently  promote cardiac arrhythmia  and ventricular fibrillation.

The risk of cardiac arrest or sudden cardiac death can be increased, particularly with high levels of exercise intensities. A bad training condition or returning to the sport after a long break can increase this many times over. Various causes and previous illnesses can lead to sudden cardiac death and occur differently in different age groups.

1. Heart muscle inflammation: myocarditis

Inflammation of the  heart muscle  (myocarditis) is usually triggered by pathogens such as viruses, bacteria or other germs, usually by delayed infections, colds or tonsillitis. These infections usually heal without any problems. In some cases, however, cardiac arrhythmias or cardiac enlargement can occur, since the left ventricle is enlarged by the inflammation and the pumping function is impaired as a result. Features are:

  • shortness of breath or shortness of breath
  • Irregular heartbeat and palpitations
  • Unusually high heart rates
  • Pain sensations in the chest area

In case of problems and pain, medical advice should be sought to avoid serious consequences.

2. Sudden cardiac death during sport: cause of coronary artery disease

In coronary heart disease, narrowing of the coronary arteries leads to insufficient blood flow to the heart and, as a result, to a heart attack. Here, the tip, the cardiac septum near the tip, which is usually scarred or thinned, is affected. If the coronary arteries are completely blocked, the heart muscle is no longer supplied with blood and dies. Common signs and symptoms are:

  • Chest pain on exertion
  • Brustenge (angina chest)
  • Pain in the left arm near the heart

People with risk factors such as smoking,  diabetes  or being overweight should seek medical advice, especially before engaging in physical activity and sport.

Hypertrophic cardiomyopathy is a pathological thickening of the heart muscle, which is usually present from birth. The heart muscle is only slightly thicker than a healthy heart, but it can be twice as thick. The problem: The inner diameter becomes smaller and thus narrows the heart cavity, the structure of the tissue is also disturbed and the elasticity of the heart muscle is restricted. Arrhythmias can occur, especially in people with a particularly thick heart and narrowing of the outflow tract of the left ventricle.

Hypertrophic cardiomyopathy occurs with a frequency of 1:500. The heart defect can be easily diagnosed. (Sports) medical check-ups in the form of listening to the heart,  ECG  and an ultrasound examination help to assess fitness for sport.

4. Malformations of the heart: congenital coronary anomalies

Congenital defects or malformations of the coronary vessels are a frequent  cause of death, especially in the first two decades of life . Common symptoms are:

  • Exercise-related chest pain
  • dizziness
  • fainting spells

A definitive diagnosis can only be made with a heart catheter – medical advice must be sought urgently in the event of symptoms.

5. Diseases of the aorta

Diseases of the main artery ( aorta ) or the aortic valves can also be causes of sudden cardiac death during sport. In most cases, the part of the cutaneous artery close to the heart is enlarged as a result of tissue disorders in the vessel wall or a particular connective tissue disease (Marfan syndrome).

People affected by Marfan syndrome often have the following characteristics:

  • Slim physique
  • Long extremities
  • Hyperextensible joints
  • Changes in the chest and spine

In studies, this syndrome was frequently diagnosed in basketball and volleyball players. The aortic wall can tear, especially during high-intensity exertion or hard physical contact. Problems or changes in the aorta can be identified using an ultrasound.

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