How to prevent sudden death due to heat strokes from sporting activities

Prior to a sporting event detecting persons who could develop cardiovascular diseases or suddenly fall dead from a cardiac arrest is a challenge. Sudden death during sporting events, especially endurance races of 10 to 20km, is likely in a high number of both professional and amateur athletes. Cardiac arrhythmia, often termed irregular heartbeat, has been reported more often than heat stroke as a cause of sudden death during sporting events.

On the other hand, Lior Yankelson, MD, and Pinchas Halpern, MD, are of a different opinion; life-threatening events during endurance races are more likely to be caused by heat stroke than by cardiac arrhythmia, especially in warm climates. The high incidence reported is not limited to sporting or endurance races but is also found in college football players, high school athletes and experienced runners who were thought to be immune.

What then are some ways to prevent heat stroke during sporting events, and other causes of cardiovascular collapse?

1. Acclimatization to warm climates

It is recommended that athletes give themselves a 10 to 14 days period of environmental acclimatization before engaging in endurance races. Event planners should also acknowledge the need for athlete proper adjustment to the racing environment. Of 10.9 million runners assessed in the United States during a 10 years period, 59 (incidence rate: 0.54 per 100,000 participants) had cardiac arrest.

2. Recently ill or persons recuperating from a febrile illness should be discouraged from participating in endurance races.

Exercising imposes heat stress on the body and elimination of body heat is necessary for proper adjustment. Fever impairs the ability of the body to do this.

3. Prompt diagnosis.

When heat stroke is promptly diagnosed, health care providers can immediately initiate cooling therapy. Athlete’s temperatures are usually monitored using rectal or core probes and where necessary, cooling procedures are instantly instituted. It is a challenge though to record core body temperatures during physical activity. A potential solution is an ingestible telemetric body core temperature sensor.

4. Routine screening.

Mandatory screening of all athletes prior to participation in competitive sports has been recommended where cardiac death is a possibility. For screening to work, the benefits should be higher than the costs, effective tests should be available, and it can be proved that avoidance will prevent the risk. Some events carry out a pre-participation electrocardiogram (ECG) screening. Exercise or cardiac stress testing have also been used. Some events require participants sign a declaration of “good health” which might not be adequate enough.

5. Don’t forget water.

Ingest adequate amount of water during sporting activities, including endurance races. Also, take electrolyte drinks and have frequent rest breaks.

Since the number of persons participating in endurance races is on the increase, (see statistics), it is important therefore to recognize the risk of sudden death during sporting events as an increased challenge.

The material from this blog piece was inspired by: Life-Threatening Events During Endurance Sports. Is Heat Stroke More Prevalent Than Arrhythmic Death?

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