Background: Sudden cardiac arrest and death (SCA/D) remains the leading
cause of mortality among athletes. Contemporary standards of identifying
normal physiological cardiac adaptations and remodeling from regular
athletic training based on certain ECG morphology have been clearly
defined by the ‘Seattle Criteria’ in 2012, with an updated ‘International
Consensus’ in 2017. In heterogenous Asia, regional SCA/D preponderance
data is still lacking. This study aims to report on the detection of potentially
dangerous cardiovascular conditions in Malaysian university athletes via
pre-participation evaluation. Methods: All 176 Malaysian athletes
competing in the 18th ASEAN University Games 2016 were requested to
attend a centralised pre-participation evaluation (PPE) prior to the games.
The PPE included history, physical examination and a resting ECG.
Participating sports and the corresponding number of athletes were athletics
(40), basketball (26), football (24), silat (16), rugby (14), badminton (14),
table tennis (12), shooting (12), fencing (10) and petanque (8). Results: A
hundred and thirteen athletes (64.2%) attended and completed the PPE. The
highest percentages of athletes screened were from shooting, fencing and
petanque (100% respectively), whilst the lowest were from the basketball
team (23.1%). Three abnormal ECGs were identified: a multiple premature
ventricular contractions, an atrial tachyarrhythmia and a ventricular preexcitation.
These three athletes were referred for subsequent investigations.
Two of them were allowed to resume play. The latter athlete was diagnosed
with Wolff-Parkinson-White syndrome and was advised against competing
until definitive management was instituted. Conclusion: Only a fair number
of Malaysian university athletes completed the medical screening. This
reflects their unawareness of the importance of PPE. Despite the small
sample size, three cases were singled out requiring further investigation and
interventional studies. No screening program provides absolute protection
against death. Thus, more evidence-based research and constant updates on the best practice guidelines are vital to foster safe sports participation to
ultimately reduce incidence of SCA/D among the athletic population.
Athletes need to be aware and give full cooperation for PPE to ensure early
detection of high-risk cardiovascular conditions especially those related to
sudden death in sports.