07/02/2026
SUDDEN CARDIAC DEATH AMONG ATHLETES
by Dr. Alan S.Tenerife
Growing up, I often heard stories in our neighborhood about young individuals who suddenly died while playing basketball or shortly after a game. There seemed to be no logical explanation behind these tragedies, but the older folks would often blame it on drinking cold water during or after playing. It’s hard to understand why apparently healthy young athletes would suddenly die under these circumstances.
So, what causes these untimely deaths?
THICKER AIN'T BETTER
In young athletes (less than 35 years old), the most common cause of sudden cardiac death is hypertrophic cardiomyopathy (HCM). People with HCM have abnormal genes that cause the walls of the left ventricle of the heart to become thickened and stiff. These changes can reduce the amount of blood filling the heart and being pumped into the body with each heartbeat.
At times, the septum or the wall between the left and right ventricles is abnormally thickened, impeding the flow of blood from the left ventricle into the aorta, a condition called hypertrophic obstructive cardiomyopathy (HOCM). This comprises two-thirds of cases of HCM, while the remainder of cases is the nonobstructive type.
SYMPTOMS
Patients with HCM may present with chest pain, exertional dyspnea, palpitations, fatigue, or syncope. Many patients remain asymptomatic.
COMPLICATIONS
HCM may lead to atrial fibrillation, stroke, and other cardioembolic events, heart failure, and the dreaded ventricular fibrillation leading to sudden cardiac arrest.
A notable example is Reggie Lewis, a former basketball player of the Boston Celtics who suddenly went into cardiac arrest during an off-season practice in July 1993. He was only 27 years old, and his demise was attributed to hypertrophic cardiomyopathy.
THE IMPORTANCE OF SCREENING
Patients with symptoms of HCM should be evaluated by a cardiologist and undergo tests such as an electrocardiogram (ECG) and a 2D echocardiogram, which will show the structural changes of HCM.
Features that predict a high risk of death include recent syncope, a history of sudden cardiac arrest related to HCM among first-degree relatives, left ventricular dysfunction (LV ejection fraction less than 50%), or significant thickening of the left ventricular wall (3 cm or more).
First-degree relatives of people diagnosed with HCM should undergo genetic testing and cardiac workup to rule out the presence of HCM since this condition can run in families.
People who participate in high-intensity sports should undergo screening and clearance from cardiologists. Patients diagnosed with HCM can still engage in light to moderate activities but should steer clear of high-intensity, competitive sports to minimize the risk of sudden cardiac arrest.
* graphic courtesy of Canva
