Cardiac Chest Pain In Athletes

Cardiac chest pain in athletes

Chest pain in athletes can be from a number of causes. Thankfully, cardiac chest pain in athletes is rare. A range of conditions causes pain in the chest. These include muscular pain and pain referred from the thoracic spine. However, you should always rule out cardiac chest pain.

What causes cardiac chest pain in young athletes?

  • Coronary heart disease.
  • Hypertrophic cardiomyopathy.
  • Aortic stenosis.
  • Acute pericarditis.
  • Pulmonary embolism.

If following a history and examination, cardiac chest pain is suspected, then you should be referred for a resting Electrocardiogram (ECG). If your ECG is normal then you may need to do an exercise test.


Sudden cardiac death syndrome

  • Sudden cardiac death syndrome is also known as sudden arrhythmic death syndrome (SADS). It is uncommon, especially in athletes or those that exercise regularly.
  • In younger athletes (under 35), the most common cause of sudden cardiac death is Hypertrophic cardiomyopathy or other structural congenital conditions.
  • Marfan syndrome is another cause of sudden cardiac death in young athletes. However, you will most likely be diagnosed with this at a young age. If you have this then you will be advised to avoid high-intensity exercise.
  • In older athletes, Coronary heart disease is the most common cause or cardiac chest pain, followed by mitral valve prolapse.

Hypertrophic cardiomyopathy

Hypertrophic Cardiomyopathy (HCM) is the most common cause of sudden cardiac death in the sporting population. HCM is a disease of the cardiac (heart) muscle resulting in an enlarged (hypertrophied) left ventricle wall. HCM is divided into two types – obstructive and non-obstructive. Obstructive HMC refers to the obstruction of the blood flow to the left ventricle.

There are rarely any cardiac symptoms or chest pain to indicate the presence of this condition before a sudden collapse during exercise. In those who do demonstrate early symptoms, these may include:

  • Chest pain.
  • Palpitations.
  • Syncope (fainting).

If HMC is suspected, an ECG may demonstrate ST segment and T wave abnormalities and a prominent Q wave. The investigation of choice, however, is an Echocardiogram. A hypertrophied left ventricle which is not dilated and no evidence of other conditions indicates the presence of HCM.

The vast majority of cases of sudden death caused by HCM occur in males.

Related articles

  • Abdominal pain in athletes

    Abdominal pain can result from direct impact or trauma to the stomach. Or it could be gastrointestinal related with abdominal cramps, nausea, diarrhea, and vomiting. Here…

  • Cardiac chest pain in athletes

    Acute chest pain is sudden onset and includes cardiac chest pain, heart attack, a torn muscle or bruised rib. Most chest pain in sport, however,…

  • Referred chest pain

    Referred chest pain is pain originates from an injury elsewhere, but is felt in the chest. The root cause of the problem may be in…

  • Asthma

    Asthma is an inflammatory disorder of the airways which causes shortness of breath and 'wheezing'. Its severity can range from mild, with only occasional symptoms,…

Scroll to Top