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European Heart Journal 1999 20(12):900-903; doi:10.1053/euhj.1998.1403
Copyright © 1999 by the European Society of Cardiology.
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Undetected cardiac lesions cause unexpected sudden cardiac death during occasional sport activity. A report of 80 cases

A report on 80 cases

A. Tabiba,f1, A. Mirasb, P. Tanierea and R. Loirea

a Department of Pathology, L.Pradel Hospital, Lyon, France
b Forensic Medecine Institute, Lyon, France

revised October 18, 1998; accepted October 20, 1998

Abstract

The retrospective analysis of 1500 forensic autopsies after sudden cardiac death showed that 80 (77 men, three women) had died following sport, for which they had been inadequately trained. The chosen sport (both dynamic and static), and the cardiac pathology discovered during autopsy make it possible to divide the population into two groups. Group 1 were those under 30 years of age (27 cases) engaged in jogging, gymnastics, rugby, tennis and boxing who suffered from hypertrophic cardiomyopathy (29·6%), arrhythmogenic right ventricular cardiomyopathy (25·9%), non-atherosclerotic (14·8%), aortic stenosis (7·4%), atrial septal defect (3·7%), stenosing coronary atherosclerosis (3·7%), and structural abnormalities of the His bundle (3·7%). Group 2 were those over 30 years of age (53 cases), engaged in swimming, cycling, jogging and football. The cardiac lesions responsible were stenosing atherosclerotic coronary disease (49%), non-atherosclerotic coronary disease (1·8%), hypertrophic cardiomyopathy (20%), obstructive cardiomyopathy (4·8%), structural abnormalities of the His bundle (7·4%), myocardic bruise scar (4%), and arrhythmogenic right ventricular cardiomyopathy (3·7%). In both groups, dilated cardiomyopathy occurred with identical frequency (11%).

Conclusions The lesions discovered are the same as those identified in professional athletes, when the body tries to avoid mortal rhythmic decompensation in the case of an over-loading volume and tension during an ill-adapted effort. Forensic autopsy should establish these anomalies because the transmissible genetic characteristics of some of them could underline the need for check-ups in other members of the family.

Key Words: Sport • sudden cardiac death

f1 Correspondence : Dr A. Tabib, Department of Pathology, L. Pradel Hospital, BP Lyon Montchat, 69394 Lyon, Cedex 03 France.

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