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Symptoms often seen before sudden death
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Kemal Atlay A LARGE proportion of young athletes who die suddenly while exercising or playing sports have symptoms just prior to the game , a study has found .
Among 110 cases of sudden cardiac death linked to sports or other exertion , 40 % had chest pain , syncope or other symptoms 30 minutes prior to their cardiac event , according to Australian coronial data .
The researchers , led by cardiologist Professor Han Lim from the University of Melbourne , found the most
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common activities linked with sudden death among people aged 10-35 were Australian rules football , running , jogging and soccer .
Overall , the researchers found a “ high occurrence ” of coronary artery disease ( CAD ) and sudden arrhythmic death syndrome , which accounted for 37 % and 20 % of deaths , respectively .
CAD was implicated in all 10 Aboriginal and Torres Strait Islander fatalities , underlining the importance of screening for cardiovascular risk factors in this cohort , the authors
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reported . Other causes of sudden cardiac death included unspecified cardiomyopathy or cardiomegaly , myocarditis and arrhythmogenic right ventricular cardiomyopathy . The research also revealed extremely low use of automated external defibrillators ( AEDs ), despite the vast majority of sudden cardiac deaths at sports clubs and community facilities being witnessed .
Seventy per cent of cases received bystander CPR , but defibrillators were used for only 8 % prior to ambulance
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arrival . Although bystander CPR could lead to improved long-term survival in out-of-hospital cardiac arrest , the authors said that the use of an AED was the “ crucial temporary bridge ”.
The researchers reviewed a total of 1925 sudden cardiac deaths recorded in the National Coronial Information System database over a 17-year period , finding 141 cases related to physical exercise , of which they had complete data on 110 people . Intern Med J 2021 ; 31 Oct .
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Football is linked to sudden cardiac death . |
Breast cancer ups AF risk
Kemal Atlay OLDER women newly diagnosed with breast cancer are at increased risk of developing AF and dying from cardiovascular disease , a new study suggests .
The US researchers looked at data on 85,000 women with early or advanced breast cancer diagnosed from 2007 to 2014 to assess the incidence , risk factors and mortality associated with concurrent AF .
They found the overall incidence of AF in patients older than 66 who had breast cancer was nearly double compared with matched controls who did not have cancer ( 3.3 % vs 1.8 %) over one year ’ s follow-up .
Among the 4 % of women with new-onset AF following their breast cancer diagnosis , there was a three- and twofold higher risk of cardiovascular and all-cause death , respectively , versus those who did not develop AF .
The study flagged cancer grade and stage as the strongest risk factors for AF development , with risk of the arrhythmia steadily increasing with disease severity .
However , increased cardiovascular and all-cause mortality was not the case for the 11 % of patients with existing AF , which the authors suggested could be because they were already well managed from a cardiovascular standpoint .
Despite significant improvements in breast cancer survival rates in recent decades , the accompanying rise in cardiovascular problems could limit “ optimal outcomes ”, the researchers wrote in the European Heart Journal .
“ Therefore , it ’ s possible that involvement of cardiooncology in the care of breast cancer patients may mitigate the mortality outcomes noted in this study ,” said lead author Dr Avirup Guha , a cardiologist from Case Western Reserve University in Ohio . Eur Heart J 2021 ; 14 Nov .
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