Sudden cardiac death (SCD) in sports is usually the result of an undiagnosed heart condition, with physical exertion acting as the trigger. Commotio cordis is a rare cause of SCD. Genetic cardiomyopathies are the most common cause in young athletes, while coronary artery disease is the most important differential diagnosis in older athletes. Regular screening programs—consisting of a medical history, physical examination, and resting ECG—can detect over 90% of relevant conditions, particularly when international ECG criteria are correctly applied. However, these examinations are not always sufficient, as some pathologies do not manifest until later and/or additional tests are required to detect the pathology. The primary goal of screening athletes is to distinguish physiological adaptations of the athlete’s heart from pathological changes. Echocardiography, MRI, and CT play a central role in this process.
This is summarized in the accompanying article.
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