An important article appeared in this week’s edition of Circulation, one of the American Heart Association (AHA) medical journals. Dr. Kimberly Harmon and her colleagues at the University of Washington wrote an article entitled, “Incidence of Sudden Cardiac Death in National Collegiate Athletic Association Athletes.”

We know that sudden cardiac death (SCD) is a sad, but thankfully uncommon, event among student athletes. As I’ve said before, these events often receive sensational attention in the popular press when they occur. Unfortunately, it has been difficult to get a handle on the number of such events because there is no required reporting of such events. As a result, various investigators have estimated the frequency of SCD to be anywhere from 1 per 23,000 athletes to 1 per 300,000 athletes.

In the newly published article, Dr. Harmon reviewed the records from the National Collegiate Athletic Association (NCAA) that pertained to student athletes who competed from 2004 through 2008. This represented 300,835 athletes aged 17 through 23 years who competed in 40 sports in all three NCAA divisions. In total, there were 1,969,663 athlete participation-years.

The investigators found 273 deaths during that period. The majority of these deaths were not sports-related, with a variety of causes such as accidents, suicides, homicides, and drug overdoses. The cause of death was medical in 80 cases and, among these, the cause was cardiac in 45. Thus, the rate of SCD in NCAA athletes works out to be 1 per 43,770 per year.

The rate of SCD was different for various sports, with the higest rates for the following sports:
Basketball: 1 per 11,394 per year
Swimming: 1 per 21,293 per year
Lacrosse: 1 per 23,357 per year
Football: 1 per 38,497 per year
Cross country: 1 per 41,695 per year.

There are several important implications of the study:

1. We should expect similar rates of SCD for closely younger (high school) and older (adult), non-student athletes. Both of these groups have many more participants than the group of college athletes that was studied.

2. Knowing that an EKG detects upwards of two-thirds of hidden cardiovascular diseases in athletes, it may be prudent to include an EKG as part of a pre-participation physical examination for athletes in the higher-risk sports.

3. Knowing the higher-risk sports may show athletic departments and event planners where to best deploy resources such as automatic external defibrillators (AED’s) and on-site health professionals to treat potential victims of SCD.