Harvard Heart Letter

Pre-sports check-up can prevent sudden death among athletes

Whether the check-up should include an electrocardiogram is an unanswered question.

Sports, and the physical fitness needed to participate in them, provide an extra layer of cardiovascular protection by strengthening the heart, improving the lungs, and making arteries more supple. Sometimes, though, something goes horribly wrong and an athlete suddenly dies while engaged in his or her sport.

In older athletes, sudden death is almost always due to cholesterol-clogged arteries. Among young athletes, more than half of sudden deaths occur because of a cardiac arrest — the sudden cessation of a normal heartbeat and blood circulation — due to an inherited condition. Some of these may be identified by a pre-sports medical exam. Exactly what should happen during that exam is a matter of intense debate.

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