Incidence of Sudden Cardiac Death in Sport in England
SV de Noronha, S Desai, MN Sheppard. Royal Brompton Hospital, Imperial College, London, United Kingdom; Royal Brompton and Harefield NHS Trust, London, United Kingdom
Background: Sudden death in healthy individuals engaged in regular sport is a rare but devastating phenomenon and is usually associated with previously undetected cardiovascular disease. We report for the first time the characteristics of a large series of sudden cardiac deaths (SCD) that occurred in England.
Design: Retrospective study of individuals engaged in sporting activity and who had a sudden cardiac death.
Results: 118 cases (6.6%) of SCD related to sport or with a regular history of sport were selected from a database of 1800 cases. The age range was 7 to 59 years (mean age, 27.9 12.5) with the majority of deaths occurring in the younger age group (75%). Males predominated (113, 96%) with only 5 female deaths (4%) mainly in younger age group. Twenty patients (17%) showed a family history of cardiovascular disease and/or family history of SCD. Fifteen (13%) had a personal history of cardiac anomalies, whilst 21 (18%) had a personal history of other diseases including: 3 cases (3%) of insulin dependent diabetes mellitus, 11 cases (9%) of asthma and 3 cases (3%) of epilepsy. Thirty-three patients (28%) displayed pre-mortem symptoms with syncope, shortness of breath and feeling unwell being the dominant features. Seven cases (6%) were athletes at a professional or semi-professional level, 6 being footballers and one a professional cyclist. Four (3%) were in the armed forces. Eighty-two percent of the remaining cases were amateur athletes with a regular participation in sport activity. The top three sports associated with the greatest number of SCD were football with 44 subjects (37%) followed by running with 24 (20%) and rugby with 11 (9%). The table below summarises our final diagnoses.
Conclusions: Sudden death in sports is rare. The main cardiac causes are cardiomyopathies, with LVH often associated with fibrosis, ARVC and HCM predominating. The presence of normal hearts in a significant number points to channelopathies being important in sport deaths. Screening of athletes should be undertaken to avoid these deaths.
Tuesday, March 10, 2009 1:00 PM
Poster Session IV # 45, Tuesday Afternoon