Sudden cardiac death in athletes--does preparticipation screening help?

Sir, A changing trend is being seen in schools of getting a health check up done and getting a cardiac clearance done by the physician for the children opting for competitive sports to avoid any mishap leading to sudden cardiac death (SCD). Sudden cardiac death is defined as an instant unexpected death which occurs in one hour of onset of symptoms most commonly due to tachyarrhythmias. Sudden cardiac death is an entity which is recognised from a long time now. It was the deaths of basketball stars Hank Gathers and Reggie Lewis in early 1990 which caught the media attention and demanded a serious attention and a focused approach to SCD.1 Since then, in the past ten years or more, a lot of research work has been done studying the causes, pathogenesis and preparticipation athletic evaluation (PAE).2 The common causes of SCD are hypertrophic cardiomyopathy (HCM), arrhythmogenic r ight ventr icular dysplasia (ARVD), congenital coronary anomalies, myocarditis, coronary artery disease, Marfan syndrome, coarctation of aorta, idiopathic left ventricular hypertrophy, hypoplastic coronary arteries, congenital heart disease, trauma to chest wall, performance enhancing drugs l ike anabol i c s te ro ids and erythropoietin, addictions like cocaine, methamphetamines, inhalants, aortic or pulmonary stenosis, Wolff-ParkinsonWhite syndrome(WPW), prolonged QT syndrome, idiopathic ventricular CorrespondenCes