Because of several well-known and high-profile cases of athletes experiencing sudden unexpected death due to cardiac arrest, such as
Reggie White and
Marc-Vivien Foé, a growing movement is making an effort to have both professional and school-based athletes screened for cardiac and other related conditions, usually through a careful medical and health history, a good family history, a comprehensive physical examination including
auscultation of heart and lung sounds and recording of
vital signs such as
heart rate and
blood pressure, and increasingly, for better efforts at detection, such as an electrocardiogram. An
electrocardiogram (ECG) is a relatively straightforward procedure to administer and interpret, compared to more invasive or sophisticated tests; it can reveal or hint at many circulatory disorders and arrhythmias. Part of the cost of an ECG may be covered by some insurance companies, though routine use of ECGs or other similar procedures such as
echocardiography (ECHO) are still not considered routine in these contexts. Widespread routine ECGs for all potential athletes during initial screening and then during the yearly physical assessment could well be too expensive to implement on a wide scale, especially in the face of the potentially very large demand. In some places, a shortage of funds, portable ECG machines, or qualified personnel to administer and interpret them (medical technicians, paramedics, nurses trained in cardiac monitoring, advanced practice nurses or nurse practitioners, physician assistants, and physicians in internal or
family medicine or in some area of cardiopulmonary medicine) exist. If sudden cardiac death occurs, it is usually because of pathological hypertrophic enlargement of the heart that went undetected or was incorrectly attributed to the benign "athletic" cases. Among the many alternative causes are episodes of isolated arrhythmias which degenerated into lethal VF and asystole, and various unnoticed, possibly asymptomatic cardiac congenital defects of the vessels, chambers, or valves of the heart. Other causes include
carditis,
endocarditis,
myocarditis, and
pericarditis whose symptoms were slight or ignored, or were asymptomatic. The normal treatments for episodes due to the pathological look-alikes are the same mainstays for any other episode of
cardiac arrest:
cardiopulmonary resuscitation, defibrillation to
restore normal sinus rhythm, and if initial defibrillation fails, administration of
intravenous epinephrine or
amiodarone. The goal is avoidance of infarction, heart failure, and/or lethal arrhythmias (
ventricular tachycardia,
ventricular fibrillation,
asystole, or
pulseless electrical activity), so ultimately to restore normal
sinus rhythm. == Management ==