For the Evaluation of Pacific Island Athletes, an ECG and Echocardiography Are Highly Recommended
Abstract
:1. Introduction
2. Incidence Rate of Sudden Cardiac Death
3. Differences between Countries
4. Differences between Sex, Ethnicity and Sports
5. Causes of Sudden Cardiac Death
6. Prevention of Sudden Cardiac Death
7. Questionnaire and Physical Examination
7.1. Medical History Questionnaires
7.2. Family History
7.3. Personal History
7.4. Physical Examination
8. Standard Twelve-Lead Resting ECG
9. Echocardiography and Other Investigations
10. Results of Sports Pre-Participation Evaluation
11. Conclusions
Funding
Acknowledgments
Conflicts of Interest
References
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Subjects | Category | n | SCD | Age | Sex | Sports | Ethnicity | Cause |
---|---|---|---|---|---|---|---|---|
Athletes (A) | Elite and Interregional | 362 | 1 | 18 | F | Shot put | Polynesian | Prolonged QT suspicion |
Elite school of sports | 431 | 0 | M | |||||
Other registered athletes | 42,655 | 1 | 17 | M | Badminton | Métis | Ventricular rhythm issue * | |
1 | 18 | M | Football | Melanesian | HCM | |||
Not registered athletes ** | 7800 | 3 | 16 15 20 | M M M | Basketball Badminton Golf | Melanesian Unknown Polynesian | Ventricular rhythm issue, Unknown, UR Unknown | |
Army ** | 1000 | 1 | 18 | M | Running | Melanesian | Ventricular rhythm issue, possible HCM previous inverted T waves | |
Total 4.4/100,000/year | 53,041 | 7 | ||||||
Non Athletes (B) | 8 | - | - | - | Melanesian | Consequence of RHD | ||
6 | - | - | - | Melanesian | Aneurysms | |||
5 | - | - | - | Melanesian | Massive heart infarction | |||
2 | - | - | - | Melanesian | Pulmonary embolism | |||
1 | - | - | - | Melanesian | Mellitus coma | |||
10 | - | - | - | Melanesian | Unknown | |||
Total 18.3/100,000/year | 58,267 | 32 | - | - | - | - | - | |
(A)+(B) | Total 11.7/100,000/year | 111,308 | 39 | - | - | - | - | - |
Authors | Country | Studied Period | Age Years | Category | Total Million | Incidence Rate /100,000 |
---|---|---|---|---|---|---|
Chatard et al., 2019 [4] | New Caledonia | 2011–2017 | 10–40 | Elite athletes Melanesian+Polynesian+Wallisian+White | 3.9 | |
2012–2014 | 10–40 | Registered and non-registered athletes Melanesian+Polynesian+Wallisian+White | 0.11 | 11.7 | ||
Harmon et al., 2011 [1] | USA | 2004–2008 | 15–24 | Black + White | 1.9 | 2.3 |
Black | 0.3 | 5.7 | ||||
White | 1.6 | 1.7 | ||||
Black male | 7.7 | |||||
Basketball | 8.8 | |||||
Male | 14.3 | |||||
Female | 2.6 | |||||
Division I | 0.8 | 34.3 | ||||
Division I Black male | 32 | |||||
Swimming | - | 4.3 | ||||
Football | - | 2.6 | ||||
Cross country | - | 2.4 | ||||
Maron et al., 2016 [6] | USA | 1980–2011 | 8–39 | White + Nonwhite | >80 | 0.6 |
Toresdahl et al., 2014 [10] | USA | 2009–2011 | College | Black + White | 4.1 | 1.1 |
Roberts et al., 2013 [11] | Minnesota | 1993–2012 | 12–19 | High school athletes | 1.7 | 0.2 |
Landry et al., 2017 [12] | Canada | 2009–2014 | 12–45 | 18.5 | 0.8 | |
Holst et al., 2010 [8] | Denmark | 2000–2006 | 12–35 | White | 1.6 | 1.2 |
Marijon et al., 2011 [7] | France | 2005–2010 | 10–35 | White | 13.4 | 1.0 |
Bohm et al., 2016 [5] | Germany | 2012–2014 | 10–79 | 0.1–0.2 | ||
Corrado et al., 1998 [13] | Italy | 1979–2004 | 12–35 | White | 36.1 | 2.1 |
Steinvil et al., 2011 [14] | Israel | 1985–2009 | 10–40 | 2.6 |
Heart Frequency | Bradycardia < 30 bpm or Pauses ≥ 3 s |
---|---|
P wave | In I and II amplitude > 2.5 mm and/or duration > 120 ms * In V1–V2, >1 mm in depth, >40 ms in duration * Atrial fibrillation, flutter, supraventricular tachycardia |
PR interval | PR < 120 ms and delta wave at the beginning of QRS and sometimes inverted T waves = WPW. Atrio-ventricular block 1° ≥ 400 ms Mobitz II, 2° block without Wenckebach phenomenon. 3° complete AV block |
Q wave | Q/R ratio 25% or > 40 ms duration in 2 or more leads except III and aVR |
QRS complex | Delta wave LBBB > 120 ms, RBBB > 120 ms * Any QRS > 140 ms Left and right axis deviation < −30° > 120° * R wave in V1 > 7 mm * R/S > 1 in V1–V2 *, R/S <1 in V5–V6 * Brugada Type 1 Epsilon wave |
ST segment | Depression > 0.5 mm in 2 or more contiguous leads Depression > 1 mm in any lead |
Inverted T wave | ≥1 mm in depth in 2 or more contiguous leads Before puberty in any lead except III, VR, V1, V2, V3 Post puberty and adult in any lead except III, VR, V1 Except V2, if IRBBB Except V2, V3 and V4 in Black athletes |
QTc | >470 ms in male, >480 ms in female <340 ms in any athlete |
Ventricular premature beat | ≥2 premature ventricular beats per 10 s tracing Doubletss, triplets and non-sustained ventricular tachycardia |
Studies | n | M% | Cat | Ethny | Age | CI | MC | LVH | WPW | QT | VA | AHT | Val | IAC | Brug |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Corrado et al., 1998 [13] | 33,735 | 85 | A | Ita | 19 | 621 | 34 | 6 • | 44 | 37 | 121 | 168 | 133 | ||
Fuller et al., 1997 [25] | 5615 | 60 | HS | Ca ? | 13–19 | 22 | 0 | 3 * | 1 | 0 | 15 | 20 | 43 | 0 | 0 |
Basavarajaiah et al., 2008 [15] | 3500 | 75 | E | 98% Ca | 20.5 | 15 | 0 | 53° | 6 | 9 | 0 | 0 | 9 | 2 | 0 |
Papadakis et al., 2011 [26] | 2745 | 100 | A | 66% Ca 33% Ba | 14–35 | 12 | 4 | 112° | 4 | 3 | 0 | 22 | 5 | 5 | 1 |
Chatard et al., 2019 [4] | 2281 | 69 | E | 31% Mel 29% Poly 21% Cau 20% Met | 10–40 | 18 | 8 | - | 6 | 5 | 8 | 6 | 35 | 8 | 0 |
Price et al., 2014 [27] | 2017 | 71 | S | 34% Ca 31% Ba | 14–18 | 5 | 1 | 1 • | 4 | 1 | 0 | 0 | 3 | 0 | 0 |
Magalski et al., 2008 [28] | 1959 | 100 | EF | 67% Ba 31% Ca | 23 | 0 | 0 | 6 • | 0 | 0 | 0 | ? | 0 | 0 | 0 |
Hevia et al., 2012 [29] | 1220 | 96 | S | Ca ? | 23 | 2 | 2 | 8 • | 4 | 0 | 4 | 0 | 0 | 0 | 0 |
Wilson et al., 2012 [17] | 1220 | 100 | AP | 66%Wa 25% Ba | 22.6 | 7 | 4 | 13 • | 2 | 1 | 1 | 10 | 2 | 1 | 0 |
Wilson et al., 2008 [30] | 1074 | 100 | J | Ca ? | 15.8 | 9 | 1 | 0 | 4 | 3 | 1 | ? | ? | ? | 0 |
Menafoglio et al., 2013 [31] | 1070 | 75 | A | 98%Ca | 19.7 | 4 | 0 | 0 | 3 | 1 | 0 | 1 | 5 | 0 | 0 |
Mayer et al., 2012 [32] | 733 | 57 | ES | Ca ? | 12.3 | 4 | 1 | 0 | 3 | 0 | 0 | 0 | 10 | 3 | 0 |
Baggish et al., 2010 [33] | 508 | 61 | S | 68% Ca 10% Ba | 19 | 3 | 2 | 2 * | 0 | 0 | 0 | 0 | 7 | 0 | 0 |
Total | 57,677 | - | - | - | - | 722 | 57 | 204 | 81 | 60 | 150 | 227 | 252 | - | - |
Mean percentage | 82 | - | - | 19.4 | 1.3 | 1.0 | 0.35 | 0.14 | 0.10 | 0.26 | 0.40 | 0.43 | - | - |
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Chatard, J.-C. For the Evaluation of Pacific Island Athletes, an ECG and Echocardiography Are Highly Recommended. Hearts 2021, 2, 270-277. https://doi.org/10.3390/hearts2020021
Chatard J-C. For the Evaluation of Pacific Island Athletes, an ECG and Echocardiography Are Highly Recommended. Hearts. 2021; 2(2):270-277. https://doi.org/10.3390/hearts2020021
Chicago/Turabian StyleChatard, Jean-Claude. 2021. "For the Evaluation of Pacific Island Athletes, an ECG and Echocardiography Are Highly Recommended" Hearts 2, no. 2: 270-277. https://doi.org/10.3390/hearts2020021