Sudden cardiac death related to physical exercise in the young: a nationwide cohort study of Australia.
Internal Medicine Journal · 2021-11-02 · Registry study
Abstract
BACKGROUND: Sudden cardiac death (SCD) during physical exercise is devastating. AIMS: To evaluate causes and circumstances of exercise-related SCD in the young in Australia. METHODS: We reviewed the National Coronial Information System database for deaths in Australia relating to cardiovascular disease in cases aged 10-35 years between 2000 and 2016. Cases who had undertaken physical exercise at the time of the event were included. We collected demographics, circumstances of death, type of physical exercise, bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use prior to ambulance arrival. RESULTS: Over a 17-year period, 1925 SCD cases were identified, of which 110 (6%) cases (median age 27 years (interquartile range 21-32 years); 92% male) were related to sports/physical exercise. Thirteen (12%) cases occurred in active athletes. Most common causes were coronary artery disease (CAD; 37%) and sudden arrhythmic death syndrome (SADS; 20%). Among Aboriginal and Torres Strait Islanders (n = 10), all deaths were related to CAD. Australian Rules Football (24%), running/jogging (14%) and soccer (14%) were the most frequent physical exercise activities. Prior symptoms were present in 39% (chest pain 37%, pre-syncope/syncope 26%). Most (87%) were witnessed, with bystander CPR in 70%. AED use prior to ambulance arrival was 8%. CONCLUSIONS: The present study demonstrates the high occurrence of CAD and SADS in SCD in the young related to physical exercise. Aboriginal and Torres Strait Islanders were disproportionately affected by CAD. Although events were commonly witnessed, AED was seldom used prior to ambulance arrival and highlights an important opportunity to improve outcomes in the post-arrest chain of survival.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Automated external defibrillator · Bystanders · Children · Mass gatherings & events · Mortality & survival · Sex & gender
Related articles
- Socioeconomic factors and outcomes from exercise-related sudden cardiac arrest in high school student-athletes in the USA. (Br J Sports Med, 2022)
- Association between basic life support and survival in sports-related sudden cardiac arrest: a meta-analysis. (Eur Heart J, 2023)
- Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review. (Br J Sports Med, 2022)
- Clinical Characteristics and Emergency Response to Sudden Cardiac Arrest/Death Secondary to Cardiomyopathies in Young Athletes. (JACC Adv, 2026)
- Disparities in Pediatric Out-of-Hospital Cardiac Arrest Outcomes Relating to Race, Urbanicity, and Poverty: A Study of the NEMSIS Database. (Prehosp Emerg Care, 2026)
- Epidemiology of sudden cardiac death and sudden cardiac arrest with resultant disability during high school organized sport in Japan. (J Sci Med Sport, 2022)