Undetected cardiac lesions cause unexpected sudden cardiac death during occasional sport activity - A report on 80 cases

The retrospective analysis of 1500 forensic autopsies after sudden cardiac death showed that 80 (77 men, three women) had died following sport, for wh ich they had been inadequately trained. The chosen sport (both dynamic and static), and the cardiac pathology discovered during autopsy make it possib le to divide the population into two groups. Group 1 were those under 30 ye ars of age (27 cases) engaged in jogging, gymnastics, rugby, tennis and box ing who suffered from hypertrophic cardiomyopathy (29.6%), arrhythmogenic r ight ventricular cardiomyopathy (25.9%), non-atherosclerotic (14.8%). aorti c stenosis (7.4%), atrial septal defect (3.7%), stenosing coronary atherosc lerosis (3.7%), and structural abnormalities of the His bundle (3.7%). Grou p 2 were those over 30 years of age (53 cases), engaged in swimming, cyclin g, jogging and football. The cardiac lesions responsible were stenosing ath erosclerotic coronary disease (49%), non-atherosclerotic coronary (1.8%), h ypertrophic cardiomyopathy (20%), obstructive cardiomyopathy (4.8%), struct ural abnormalities of the His bundle (7.4%). myocardic bruise scar (4%), an d arrhythmogenic right ventricular cardiomyopathy (3.7%). In both groups, d ilated cardiomyopathy occurred with identical frequency (11%). Conclusions The lesions discovered are the same as those identified in prof essional athletes, when the body tries to avoid mortal rhythmic decompensat ion in the case of an over-loading volume and tension during an ill-adapted effort. Forensic autopsy should establish these anomalies because the tran smissible genetic characteristics of some of them could underline the need for check-ups in other members of the family.