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Sweeting J, Semsarian C. Sudden Cardiac Death in Athletes. Heart Lung Circ 2018; 27:1072-1077. [PMID: 29705387 DOI: 10.1016/j.hlc.2018.03.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/21/2018] [Indexed: 11/25/2022]
Abstract
Sudden cardiac death (SCD) in athletes is a rare but tragic complication of a number of cardiovascular diseases. Inherited causes such as the structural and arrhythmogenic genetic heart conditions are often found or suspected to be the underlying cause of death at post mortem examination. Physical activity and intense exercise may trigger cardiac arrhythmias in individuals with these conditions leading to SCD. Prevention and treatment strategies include individual athlete management strategies, coupled with public health measures such as universal cardiopulmonary resuscitation (CPR) training and availability of automatic external defibrillators (AEDs) in public places, thereby preventing SCD in both athletes and the general population. Where an athlete is known to have a cardiac condition, some restrictions from participation may be prudent, however, new evidence is emerging that perhaps current restrictions are too strict and could be relaxed in some cases. An athlete-centred model of care is essential to ensure the clinical implications and athlete preferences are balanced providing the best outcome for all concerned.
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Affiliation(s)
- Joanna Sweeting
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
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D'Ovidio C, Carnevale A, Grassi VM, Rosato E, Del Olmo B, Coll M, Campuzano O, Iglesias A, Brugada R, Oliva A. Sudden death due to catecholaminergic polymorphic ventricular tachycardia following negative stress-test outcome: genetics and clinical implications. Forensic Sci Med Pathol 2017; 13:217-225. [PMID: 28405885 DOI: 10.1007/s12024-017-9862-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 10/19/2022]
Abstract
This paper discusses the case of a young boy who died suddenly during a football match. The victim's personal and family medical histories were negative for cardiac events. He had undergone a cardiological investigation some months before his death, enabling him to participate in competitive sports. Only post-mortem molecular analysis allowed for a clearer determination of the most plausible cause of death, which was identified as inherited arrhythmogenic heart disease, known as catecholaminergic polymorphic ventricular tachycardia. It was possible to detect a novel, previously undescribed, variant in the RYR2 gene. This case report highlights the importance of a meaningful forensic multidisciplinary investigation in such cases, and also discusses possible medical malpractice claims.
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Affiliation(s)
- Cristian D'Ovidio
- Section of Legal Medicine, Department of Medicine and Aging Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Aldo Carnevale
- Section of Legal Medicine, Department of Medicine and Aging Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Vincenzo M Grassi
- Institute of Public Health, Legal Medicine Section, Catholic University, School of Medicine, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Enrica Rosato
- Section of Legal Medicine, Department of Medicine and Aging Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Bernat Del Olmo
- Cardiovascular Genetics Centre, University of Girona-IDIBGI, Girona, Spain
| | - Monica Coll
- Cardiovascular Genetics Centre, University of Girona-IDIBGI, Girona, Spain
| | - Oscar Campuzano
- Cardiovascular Genetics Centre, University of Girona-IDIBGI, Girona, Spain
| | - Anna Iglesias
- Cardiovascular Genetics Centre, University of Girona-IDIBGI, Girona, Spain
| | - Ramon Brugada
- Cardiovascular Genetics Centre, University of Girona-IDIBGI, Girona, Spain
| | - Antonio Oliva
- Institute of Public Health, Legal Medicine Section, Catholic University, School of Medicine, Largo Francesco Vito 1, 00168, Rome, Italy.
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Lucas C, Kerkhof DL, Briggs JE, Corrado GD. The Use of Echocardiograms in Preparticipation Examinations. Curr Sports Med Rep 2017; 16:77-83. [DOI: 10.1249/jsr.0000000000000341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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