Causes and Risk Factors of Sudden Cardiac Death in Athletes: Demographic and Environmental Impacts and the Importance of Screening – A Literature Review

Abstract Aim The review focuses on understanding the etiological, demographic, and external contributors to sudden cardiac death in athletes, while also introducing a screening model and specifying the most important diagnostic methods. Materials and Methods A systematic review was conducted, including meta-analyses, randomized controlled trials, and systematic reviews published between 1998 and 2024, involving professional athletes of different ages and sporting disciplines. Results Sudden cardiac death (SCD) among athletes arises from a complex interaction of individual predispositions, the nature of the sport, and training environments. The estimated incidence is approximately 1 per 40,000–80,000 person-years. Men exhibit a higher risk than women, attributable to both biological factors and differing patterns of sports engagement. In athletes under 35, hypertrophic cardiomyopathy is the predominant cause, whereas coronary artery disease is most frequent in those over 35. The highest SCD rates occur in basketball and football, likely due to the considerable cardiovascular demands of high-intensity activity. Current meta-analyses indicate that COVID-19 does not significantly elevate SCD risk, whereas doping substantially increases mortality. Preventive strategies include pre-participation screening, timely access to automated external defibrillators (AEDs), and immediate resuscitation. Conclusion Sudden cardiac death (SCD) in athletes is an uncommon event, with risk determined by age, sport type, and individual characteristics. Despite variations in SCD incidence among different athletic populations, systematic screening remains essential for preventing fatal cases. Optimal prevention strategies should include structured screening programs, targeted education, personalized risk evaluation, and immediate access to automated external defibrillators (AEDs) along with adequate first aid training. Keywords and search strategies: sudden cardiac death, SCD, SCA, athletes, sport, hypertrophic cardiomyopathy, AAS, anabolic-androgenic steroidsAdditional filters: myocarditis, coronary artery disease, prevention, screening