Fatal arrhythmia in a juvenile athlete due to myocardial hypertrophy and infarction

This report is a case history of a 16-year-old highly trained athlete who s uffered from ventricular fibrillation during exhaustive physical activity. After resuscitation and admission into hospital ECG revealed posterior wall infarction. Thrombolytic therapy was advised and ST-segment elevation reve rsed. Within 48 h cerebral edema evolved due to hypoxic brain damage and th e subject deceased after 16 days despite prolonged maximum antiedematous th erapy. Autopsy confirmed the diagnosis of concentric myocardial hypertrophy (total heart weight 568 g) without signs of coronary artery disease. Syste mic inflammatory diseases and drug abuse were ruled out by lab studies, evi dence for viral infection was not found. Thus, relative coronary insufficie ncy in regard to myocardial hypertrophy during excessive athletic activity must be viewed as cause for the fatal arrhythmia.