Plotse hartdood bij jonge sporters: Oorzaken, aanbevelingen en screening

Sudden cardiac death in athletes has a tremendous social impact. In the Netherlands it accounts for 200 to 300 deaths each year with many different causes. For athletes under 35 years of age the cause is most often genetic (ion channelopathies, cardiomyopathy, aberrant coronary artery), for athletes over 35 years of age the most common cause is coronary artery disease. Physical activity will lead to adaptations of the muscle of the heart. Therefore, physical activity will also give rise to changes on the ECG. Often it is very difficult to distinguish these physiological changes from pathology (e.g. the Brugada syndrome or right ventricular dysplasia). Several different proposals have been pointed concerning sports participation while suffering a genetic heart disease. Participation at recreational sports can often be tolerated; participation at competitive sports should always be prohibited. However, these proposals hardly take into account the different genetic heart diseases with their different (typical) triggers for cardiac arrhythmias. A screening program has been developed for athletes under 35 years of age. This so called "Lausanne Protocol" consists of a questionnaire, a physical examination and a resting ECG. Further examination by a sports cardiologist must be done with one or more positive findings. A screening program like the "Lausanne Protocol" can be a good base for further scientific research to get more insight in the (patho) physiological changes of the ECG of athletes.