Selected issues of risk stratification and prevention of sudden cardiac death in athletes under extreme loads

Аim. The paper aims to improve preventive cardiovascular care through the awareness of the etiology and risk factors of sudden cardiac death in athletes under extreme loads with a history of pathological conditions. Materials and methods. The latest scientific and applied data published in clinical guidelines (Ventricular arrhythmias. Ventricular tachycardias and sudden cardiac death. 2020 Clinical guidelines.) approved by the ministry of health of Russia in 2020, Russian Guidelines for Sudden Cardiac Death Risk Assessment and Prevention (under the chairmanship of A. Ardashev, 2018), and scientific publications over 10 years were used for better stratification and validation of sudden cardiac death risk factors in athletes. Results. Our comprehensive analysis of the predictors of sudden cardiac death in athletes and people experiencing physical, emotional, and other stresses showed that the majority of cases were asymptomatic and, therefore, did not result in undergoing physical examination. At the same time, only a special cardiac examination allows to detect values outside of physiological standards. Therefore, a list of cardiac diseases that can remain asymptomatic for a long time is provided. Conclusion. In many cases, sudden cardiac death can be prevented by explaining to athletes and people under extreme loads the necessity to care for the cardiovascular and other systems, implementing innovative diagnostic technologies, and undergoing cardiac examination on a regular basis.