Cardiac Issues in Football

Although relatively rare, sudden cardiac death (SCD) is the most common medical cause of death in football athletes. There are advantages and disadvantages to the various screening strategies used to identify those at risk. Screening strategies can include a combination of history, physical examination, 12-lead electrocardiogram (ECG), echocardiography, and exercise testing. Secondary prevention strategies start with an emergency action plan (EAP). Specific etiologies of cardiac morbidity in football players including hypertrophic cardiomyopathy (HCM), aortic diseases, coronary artery anomalies/coronary artery disease (CAD), Wolff-Parkinson-White (WPW) syndrome, long QT syndrome (LQTS), hypertension (HTN), and myocarditis are discussed. The increasing recognition of cardiac conditions in athletes combined with increased appreciation for patient autonomy has led to an evolving concept of shared decision making, which will be discussed in this chapter in addition to legal precedents involving the cardiac care of athletes.