TY - JOUR PY - 2016// TI - Medico-legal perspectives on sudden cardiac death in young athletes JO - International journal of legal medicine A1 - Oliva, Antonio A1 - Grassi, Vincenzo M. A1 - Campuzano, Oscar A1 - Brión, María A1 - Arena, Vincenzo A1 - Partemi, Sara A1 - Coll, Monica A1 - Pascali, Vincenzo L. A1 - Brugada, Josep A1 - Carracedo, Angel A1 - Brugada, Ramon SP - 393 EP - 409 VL - 131 IS - 2 N2 - Sudden cardiac death (SCD) in a young athlete represents a dramatic event, and an increasing number of medico-legal cases have addressed this topic. In addition to representing an ethical and medico-legal responsibility, prevention of SCD is directly correlated with accurate eligibility/disqualification decisions, with an inappropriate pronouncement in either direction potentially leading to legal controversy. This review summarizes the common causes of SCD in young athletes, divided into structural (hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, congenital coronary artery anomalies, etc.), electrical (Brugada, congenital LQT, Wolf-Parkinson-White syndrome, etc.), and acquired cardiac abnormalities (myocarditis, etc.). In addition, the roles of hereditary cardiac anomalies in SCD in athletes and the effects of a positive result on them and their families are discussed. The medico-legal relevance of pre-participation screening is analyzed, and recommendations from the American Heart Association and European Society of Cardiology are compared. Finally, the main issues concerning the differentiation between physiologic cardiac adaptation in athletes and pathologic findings and, thereby, definition of the so-called gray zone, which is based on exact knowledge of the mechanism of cardiac remodeling including structural or functional adaptions, will be addressed.
Language: en
LA - en SN - 0937-9827 UR - http://dx.doi.org/10.1007/s00414-016-1452-y ID - ref1 ER -