Sudden Cardiac Death in Young Athletes

The article by Halabchi et al. provides a comprehensive, thoughtful and balanced analysis of the literature on sudden cardiac death (SCD) in young athletes [1]. The article is unique in providing a special perspective for Asia as contrasted with those in Europe and the United States. This aspect is extremely important to recognize for the management of young athletes in different parts of the world. In the United States, the history and physical examination (H&P) has been the standard of cardiovascular screening for competitive athletes, although several studies have questioned the efficacy of the screening H&P alone in identifying athletes at risk for cardiovascular adverse events [2-6]. The H&P has come under scrutiny for having low sensitivity for identifying athletes with cardiovascular risk factors. Several studies have reported data substantiating the higher efficacy of electrocardiogram (ECG) in identifying athletes with hypertrophic cardiomyopathy (HCM), channelopathies, and other clinically silent cardiovascular diseases that increase the risk for SCD in young athletes [2