JACC Case Rep. 2026 Mar 28:107653. doi: 10.1016/j.jaccas.2026.107653. Online ahead of print.
ABSTRACT
BACKGROUND: Regular physical activity confers substantial cardiovascular benefits, yet it may in rare cases precipitate sudden cardiac arrest (SCA) or sudden cardiac death (SCD) in predisposed individuals. Although preventive frameworks have largely targeted competitive athletes, the rapidly expanding population of recreational participants remains insufficiently addressed.
CASE SUMMARY: Recreational athletes have a low but significant incidence of SCA/SCD (0.02 to 13 per 100,000 person-years). Coronary artery disease is most common in middle-aged individuals, while inherited cardiomyopathies account for fewer cases.
DISCUSSION: Contemporary preparticipation evaluation for recreational athletes has shifted from universal electrocardiogram-based screening to a risk-stratified, individualized approach emphasizing cardiovascular assessment, symptom recognition, and selective testing based on exercise intensity. Digital and wearable technologies are under evaluation to support symptom-triggered assessment and cardiac rhythm documentation; however, their effectiveness for preventing sports-related SCA/SCD and their optimal clinical workflows remain unproven.
TAKE-HOME MESSAGE: Risk-based, symptom-driven preparticipation evaluation enhances safety, reduces unnecessary testing, and promotes lifelong participation in recreational sports.
PMID:42065696 | DOI:10.1016/j.jaccas.2026.107653