Summary

Exercise-induced syncope in young athletes and risk of sudden death: clinical and genetic perspectives

González Armengol JJ, López Farré A, Prados Roa F

Affiliation of the authors

Servicio de Urgencias. Unidad de Investigación Cardiovascular. Hospital Clínico San Carlos. Madrid, Spain. SAMUR-Protección Civil. Ayuntamiento de Madrid, Spain.

DOI

Quote

González Armengol JJ, López Farré A, Prados Roa F. Exercise-induced syncope in young athletes and risk of sudden death: clinical and genetic perspectives. Emergencias. 2011;23:47-58

Summary

Syncope may be a warning sign of potentially serious and even life-threatening medical

conditions. Emergency service expertise is essential for assessing risk in patients with

syncope. A focused medical history and a physical examination that includes a 12-lead

electrocardiogram (ECG) will identify the causes of syncope in half the patients. Patients

at risk are those with certain ECG abnormalities, a history of heart disease, elevated

systolic pressure, changes in breathing pattern, a fall in the hematocrit level, older age,

exercise-induced syncope, or a family history of sudden death. Structural heart disease

(congenital heart disease or primary electrical abnormalities) are the main risk factors of

sudden cardiac death (SCD) and all mortality in patients with syncope. The diagnostic

sensitivity of conventional tests remains low in these patients. SCD is normally due to

sustained tachycardia (ventricular fibrillation). The most common cause overall is

ischemic heart disease, but in patients under the age of 35 years a series of diseases have

been implicated as the most frequent causes. The past 2 years have seen studies of

genetic factors involved in cardiovascular disease that have suggested the possibility of

diagnosis for certain patients with congenital heart diseases that predispose them to

SCD. This review includes discussions of such conditions as arrhythmogenic right

ventricular dysplasia, obstructive hypertrophic cardiomyopathy, congenital long QT

syndrome, catecholaminergic ventricular tachycardia, Wolf-Parkinson-White syndrome,

or Brugada syndrome.

 

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