Can sudden death in young people be prevented?

It sometimes can. If you're at high risk of sudden cardiac death, your doctor will usually suggest that you avoid competitive sports. Depending on your underlying condition, medical or surgical treatments may be recommended to reduce your risk of sudden death.

Another option for some, such as those with hypertrophic cardiomyopathy, is an implantable cardioverter-defibrillator (ICD). This is a pager-sized device implanted in your chest like a pacemaker. An ICD continuously monitors your heartbeat. If a life-threatening arrhythmia occurs, the ICD delivers electrical shocks to restore a normal heart rhythm.

Who should be screened for sudden death risk factors?

There's debate in the medical community about screening young athletes to attempt to identify those at high risk of sudden death.

Some countries such as Italy screen young people with the use of an electrocardiogram (ECG or EKG), which records the electrical signals present in the heart. However, this type of screening sometimes leads to false-positive results — indications that an abnormality or disease is present when in fact it is not — which can cause unnecessary worry and additional tests.

It's not clear that sudden cardiac death can be prevented by the types of routine physical exams that are often necessary to be cleared to play competitive sports.

There are some things you can do if you're worried about your risk factors. For example, if someone in your family dies young, it's important that an autopsy be done to determine the cause of death. If the autopsy shows that a heart condition caused the death, screening of family members may be necessary.

For example, if the autopsy showed hypertrophic cardiomyopathy, it's recommended that all first-degree relatives of the deceased be checked for this condition, including parents, siblings and children. Repeat screening of family members is recommended over time, even if the first evaluation of their heart was normal.

Should young people avoid physical activity if they have a heart defect?

If you're at risk of sudden cardiac death, talk to your doctor about your physical activity level. Whether you can participate in exercise or sports depends on your condition.

For some disorders, such as hypertrophic cardiomyopathy, it's often recommended that you avoid most competitive sports, but this doesn't mean that you will need to avoid exercise altogether. Talk to your doctor about what sort of activities and behaviors you should avoid.

April 14, 2014