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Sat, 31 October 2020

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Cardiac Risk in the Young

Address

Unit 1140B, The Axis Centre Cleeve Road Leatherhead KT22 7ND

Statistics

Every week in the UK, 12 apparently fit and healthy young people aged 35 and under die from undiagnosed cardiac conditions.

Papadakis, M., Sharma, S., Cox, S., Sheppard, M.N., Panoulas, V.F. and Behr, E.R.
“The magnitude of sudden cardiac death in the young: a death certificate-based review in England and Wales.”
Europace 2009 Vol.11, No.10, p1353-1358 [Abstract]

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80% of SADS (sudden arrhythmic death syndrome) deaths occur at rest or during sleep.

Mellor G, Raju H, de Noronha SV, Papadakis M, Sharma S, Behr ER, Sheppard MN.
“Clinical characteristics and circumstances of death in the sudden arrhythmic death syndrome.”
Circ Arrhythm Electrophysiol. 2014 Dec;7(6):1078-83. doi: 10.1161/CIRCEP.114.001854. Epub 2014 Sep 28. [Article]

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CRY’s research is reducing the cost of cardiac screening.

Harshil Dhutia, MBBS, BSc; Aneil Malhotra, MBBChir, MA, MSc; Vincent Gabus, MD; Ahmed Merghani, MBBS, BmedSci; Gherardo Finocchiaro, MDa; Lynne Millar, MBBS; Rajay Narain, MBBSa; Michael Papadakis, MD, MBBSa; Huseyin Naci, PhDb; Maite Tome, MD, PhD; Sanjay Sharma, MD, MBChB, BSc
“Cost Implications of Using Different ECG Criteria for Screening Young Athletes in the United Kingdom”
J Am Coll Cardiol. 2016;68(7):702-711. doi:10.1016/j.jacc.2016.05.076 [Article]

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CRY’s research is improving the way young people are screened.

Nabeel Sheikh, Michael Papadakis, Saqib Ghani, Abbas Zaidi, Sabiha Gati, Paolo Emilio Adami, François Carré, Frédéric Schnell,Mathew Wilson, Paloma Avila, William McKenna and Sanjay Sharma

“Comparison of Electrocardiographic Criteria for the Detection of Cardiac Abnormalities in Elite Black and White Athletes”

Circulation April 22, 2014, Volume 129, Issue 16 [Article]

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ARVC (arrhythmogenic right ventricular cardiomyopathy) is the most likely cardiac condition to cause young sudden death during exercise.

Gherardo Finocchiaro, MDa; Michael Papadakis, MBBS, MDa; Jan-Lukas Robertus, MDb; Harshil Dhutia, MBBSa; Alexandros Klavdios Steriotis, MD, PhDa; Maite Tome, MD, PhDa; Greg Mellor, MBChBa; Ahmed Merghani, MBBSa; Aneil Malhotra, MBBChira; Elijah Behr, MBBS, MDa; Sanjay Sharma, MBChB, MDa; Mary N. Sheppard, MBBCh, BAO, MDb

“Etiology of Sudden Death in Sports”

J Am Coll Cardiol. 2016;67(18):2108-2115. doi:10.1016/j.jacc.2016.02.062 [Article]

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A national programme for systematic pre-participation screening of all young competitive athletes has been in place in Italy since 1971. Research confirms that ECG testing is the most cost effective way to test for cardiac abnormalities. A competitive athlete was defined as a participant in an organised sports programme requiring regular training and competition – thus schoolchildren would be included in the programme.

Domenico Corrado, M.D., Cristina Basso, M.D., Maurizio Schiavon, M.D., and Gaetano Thiene, M.D.
“Screening for Hypertrophic Cardiomyopathy in Young Athletes”
N Engl J Med 1998; 339:364-369 August 6, 1998 [Full Text]

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One in every 300 of the young people that CRY tests will be identified with a potentially life threatening condition.

Wilson, M.G., Basavarajaiah, S., Whyte, G.P., Cox, S., Loosemore, M. and Sharma, S.
“Efficacy of personal symptom and family history questionnaires when screening for inherited cardiac pathologies: the role of electrocardiography.”
British Journal of Sports Medicine 2008 Vol.42, No.3, p207-211 [Abstract]

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Although screening will not identify all young people at risk, in Italy, where screening is mandatory for all young people engaged in organised sport, they have reduced the incidence of young sudden cardiac death by 89%.

Corrado, D., Basso, C., Pavei, A., Michieli, P., Schiavon, M. and Thiene, G.

“Trends in Sudden Cardiovascular Death in Young Competitive Athletes after Implementation of a Preparticipation Screening Program.”
The Journal of the American Medical Association 2006 Vol.296, No.13, p1593-1601 [Full Text]

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Pre-participation cardiovascular evaluation of young competitive athletes by 12-lead ECG (in addition to history and physical examination) is warranted on the basis of the available evidence, coming from the 25-year Italian experience, that athletes affected by HCM are successfully identified and athletic field deaths reduced.

Corrado et al 

ESC Concensus statement –
European Heart Journal (2005) 26, 516–524 [Full Text]

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The risk of SCD in young athletes is increased 2.8-fold compared with non-athletes of similar age.

Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G.
Does sport activity enhance the risk of sudden death in adolescents and young adults?
J. Am. Coll. Cardiol. 42, 1959–1963 (2003). [Full Text]

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