Sudden Cardiac Death in Athletes: Risk Factors, Screening and Prevention

Abstract

Background: Sudden cardiac death (SCD) in athletes is rare, but it remains an important problem because it may occur unexpectedly in individuals with no previously recognized cardiovascular disease. Its causes differ with age and include cardiomyopathies, coronary artery abnormalities, myocarditis, coronary artery disease and primary electrical disorders. Aim: To summarize current evidence on the epidemiology, causes, risk factors and warning signs of SCD in athletes, and to discuss cardiovascular screening, prevention, emergency management and return to sport. Materials and methods: A narrative review was conducted using PubMed, Web of Science and Google Scholar. English-language full-text studies published between 2015 and 2026 were considered, including original studies, systematic reviews, meta-analyses and narrative reviews. Results: SCD is uncommon, but its incidence varies between athlete populations and is higher in males. In younger athletes, cardiomyopathies, coronary artery anomalies and primary electrical disorders are important causes, while coronary artery disease becomes more relevant with age. ECG screening may improve the detection of cardiovascular conditions associated with SCD, although its effect on mortality remains uncertain. Early CPR and rapid AED use are consistently associated with better survival after sports-related cardiac arrest. Conclusions: Prevention should combine cardiovascular assessment with awareness of warning symptoms and effective emergency preparedness. Return-to-sport decisions should be individualized according to the underlying cardiovascular condition and follow-up findings.