Prevalence of sudden cardiac death during competitive sports activities inMinnesota high school athletes

Objectives. Reliable prevalence data would be useful in assessing the impac t of sudden cardiac death in young competitive athletes on the community an d designing effective preparticipation screening strategies. Background. The frequency with which these catastrophes occur is largely un known. Methods. We utilized a circumstance unique to Minnesota in which the precis e number of participants and deaths due to cardiovascular disease could be ascertained over a substantial period of time based on a long-standing insu rance program for catastrophic injury or death, mandatory for all student a thletes engaged in interscholastic sports. Results. Over the 12-year period, 1985/1986 to 1996/1997, inclusive, three sudden deaths due to cardiovascular disease occurred in competitive high sc hool athletes (grades 10-12) during competition or practice. At autopsy, 1 each proved to be due to anomalous origin of the left main coronary artery from the right sinus of Valsalva, congenital aortic valve stenosis (with bi cuspid valve) and myocarditis. All three athletes were white and male, 16 o r 17 years of age; two competed in cross country/track and one in basketbal l. During the study period there were 1,453,280 overall sports participatio ns and 651,695 student athlete participants among the 27 high school sports . The calculated risk for sudden death was 1:500,000 participations and 1:2 17,400 participants per academic year (or 0.46/100,000, annually). Over a 3 year high school career for a student athlete the estimated risk was 1:72, 500. Conclusions. The risk of sudden cardiac death in a population of high schoo l student athletes was small, in the range of one in 200,000 per year, and was higher in male athletes. The rare occurrence of sudden cardiac death in competitive sports underlines the limitations implicit in structuring prod uctive and cost-effective broad-based preparticipation screening strategies for high school athletes. (J Am Coll Cardiol 1998;32:1881-4) (C) 1998 by t he American College of Cardiology.