Investigating the Causes of Nontraumatic Sudden Death during Sport Activities in Isfahan Province, Iran

Document Type : مقاله کوتاه

Authors

1 Department of Sports Injuries, Khorasgan (Isfahan) Branch, Islamic Azad University, Isfahan, Iran

2 Professor, Department of Sports Injuries, School of Sport Sciences, University of Isfahan, Isfahan, Iran

3 Specialist in Sports Medicine and Forensic Medicine, Isfahan, Iran

Abstract

Background: Considering today's life, sports and physical activities are of special importance in people’s health. Athletes, as a unique part of the society, are very famous and children and teenagers look at them as heroes. But, they are at the risk of sudden death mainly because of unknown origin. Since there is little information about the causes of sudden death among the athletes in Iran, this study aimed to assess the causes of nontraumatic sudden death during sport activities in Isfahan province, Iran, according to the data of Isfahan Legal Medicine Organization.Methods: In this retrograde descriptive study, considering the data of Isfahan Legal Medicine Organization, 32942 file of the Division of Decedents from the years 2003 to 2013 were investigated; in some cases, the pathological samples were studied again to confirm the diagnosis and in some others, their families were asked to complete the data. Finally, the sample consisted of 30 cadavers (27 men and 3 women) who were divided to 2 groups of under and over the age of 35 years. Findings were presented using tables and charts. Findings: Hypertrophic cardiomyopathy (HCM) was the most common cause of death seen in 11 cases (37%), 9 of them were of the group of under 35 years. Second prevalent cause was ischemic coronary atherosclerosis in 9 cases (30%), 3 of were of the group of under 35 years. Mitral valve prolapse was seen in 2 cases (7%) both of the group of under 35 years. Coronary and cerebral arteries abnormalities each one were seen in one case (3%) both of the group of under 35 years where as myocardial dysplasia was seen in 1 case (3%) of the group over 35 years. Other causes were identified in 4 cases (13%) of the group of less than 35 years. Conclusion: Based on this study, the most common cause of nontraumatic sudden death during sport activities in Isfahan Province was severe coronary atherosclerosis for the ages of over 35 years hypertrophic cardiomyopathy for the ages of less than 35 years.

Keywords

References

  1. Gheshlaghi F, Eizadi-Mood N, Montazeri G. A survey of sudden natural death prevalence in Isfahan. Sci J Forensic Med 2005; 11(2): 77-82. [In Persian].
  2. Virmani R, Burke AP, Farb A. Sudden cardiac death. Cardiovasc Pathol 2001; 10(5): 211-8.
  3. State-specific mortality from sudden cardiac death--United States, 1999. MMWR Morb Mortal Wkly Rep 2002; 51(6): 123-6.
  4. Gordon T, Kannel WB. Premature mortality from coronary heart disease. The Framingham study. JAMA 1971; 215(10): 1617-25.
  5. Greene HL. Sudden arrhythmic cardiac death--mechanisms, resuscitation and classification: the Seattle perspective. Am J Cardiol 1990; 65(4): 4B-12B.
  6. Gillum RF. Sudden coronary death in the United States: 1980-1985. Circulation 1989; 79(4): 756-65.
  7. Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 2006; 296(13): 1593-601.
  8. Corrado D, Pelliccia A, Bjornstad HH, Vanhees L, Biffi A, Borjesson M, et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005; 26(5): 516-24.
  9. Maron BJ, Carney KP, Lever HM, Lewis JF, Barac I, Casey SA, et al. Relationship of race to sudden cardiac death in competitive athletes with hypertrophic cardiomyopathy. J Am Coll Cardiol 2003; 41(6): 974-80.
  10. Maron BJ, Thompson PD, Ackerman MJ, Balady G, Berger S, Cohen D, et al. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation 2007; 115(12): 1643-455.
  11. Fuster V, Alexander RW, Wellens HJJ. Hurst's the heart. 10th ed. New York, NY: McGraw-Hill; 2000. p. 1015-32.
  12. Maron BJ. Sudden death in young athletes. N Engl J Med 2003; 349(11): 1064-75.
  13. Holst AG, Winkel BG, Theilade J, Kristensen IB, Thomsen JL, Ottesen GL, et al. Incidence and etiology of sports-related sudden cardiac death in Denmark--implications for preparticipation screening. Heart Rhythm 2010; 7(10): 1365-71.
  14. Jouven X, Desnos M, Guerot C, Ducimetiere P. Predicting sudden death in the population: the Paris Prospective Study I. Circulation 1999; 99(15): 1978-83.
  15. Maron BJ, Shirani J, Poliac LC, Mathenge R, Roberts WC, Mueller FO. Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. JAMA 1996; 276(3): 199-204.
  16. Phillips M, Robinowitz M, Higgins JR, Boran KJ, Reed T, Virmani R. Sudden cardiac death in Air Force recruits. A 20-year review. JAMA 1986; 256(19): 2696-9.
  17. Pilichou K, Nava A, Basso C, Beffagna G, Bauce B, Lorenzon A, et al. Mutations in desmoglein-2 gene are associated with arrhythmogenic right ventricular cardiomyopathy. Circulation 2006; 113(9): 1171-9.
  18. Syrris P, Ward D, Asimaki A, Evans A, Sen-Chowdhry S, Hughes SE, et al. Desmoglein-2 mutations in arrhythmogenic right ventricular cardiomyopathy: a genotype-phenotype characterization of familial disease. Eur Heart J 2007; 28(5): 581-8.
  19. Sato T, Nishio H, Suzuki K. Sudden death during exercise in a juvenile with arrhythmogenic right ventricular cardiomyopathy and desmoglein-2 gene substitution: a case report. Leg Med (Tokyo) 2011; 13(6): 298-300.
  20. Benjamin I, Griggs RC, Wing EJ, Fitz JG, Andreoli TE. Andreoli and Carpenter's Cecil Essentials of Medicine. 8th ed. Philadelphia, PA: Saunders; 2010.
  21. Kumar V, Abbas AK, Aster JC. Robbins & Cotran Pathologic Basis of Disease. 9th ed. Philadelphia, PA: Elsevier; 2014.
  22. Van Camp SP, Bloor CM, Mueller FO, Cantu RC, Olson HG. Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc 1995; 27(5): 641-7.
  23. Patel V. Sudden death in athletes. Clinical Medicine 2012; 12(3): 253-6.
  24. Awad MM, Dalal D, Tichnell C, James C, Tucker A, Abraham T, et al. Recessive arrhythmogenic right ventricular dysplasia due to novel cryptic splice mutation in PKP2. Hum Mutat 2006; 27(11): 1157.
  25. Waller BF, Roberts WC. Sudden death while running in conditioned runners aged 40 years or over. Am J Cardiol 1980; 45(6): 1292-300.
Journal of Isfahan Medical School
Volume 34, Issue 390 - Serial Number 390
May and June 2016
Pages 811-816

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History

  • Receive Date: 23 May 2015
  • Revise Date:
  • Accept Date: 06 April 2022

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