samedi 7 avril 2018

Sudden death in young athletes: mainly cardiovascular and very undetected previous the event

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5532197/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5033115/

Heritable and acquired cardiomyopathies and channelopathies

The heritable cardiomyopathies including hypertrophic cardiomyopathy (HCM), arrhythmogenic right ventricular cardiomyopathy (ARVC), dilated cardiomyopathy, and left ventricular non-compaction cardiomyopathy and the heritable channelopathies including long QT syndrome (LQTS), short QT syndrome, Brugada syndrome (BrS), and catecholaminergic polymorphic ventricular tachycardia are potentially lethal but highly treatable genetic heart diseases. The estimated incidence for each of these entities varies, but is thought for the more common diagnoses to be about 1:500 persons for HCM and about 1:2000 persons for LQTS.
Figure 2. Flow diagram summarizing causes of death in 1866 young competitive athletes. *Suicide (n=22); lightning (n=12); drowning (n=10 and 3 during the swimming segment of triathlon events); cerebral aneurysm (n=9); rhabdomyolysis (n=8); epilepsy (n=2); and miscellaneous (n=4). †Congenital heart disease (n=8); myocardial infarction (n=6); Kawasaki disease or related conditions (n=5); sickle cell trait (n=5); sarcoidosis (n=4); stroke (n=3); cardiac tumor (n=1); conduction system disease (n=2); and miscellaneous (n=2). ‡Regarded as possible (not definitive) evidence for hypertrophic cardiomyopathy at autopsy with mildly increased left ventricular wall thickness (18±4 mm) and heart weight (447±76 g). **Of wrong sinus origin coursing between aorta and pulmonary trunk; most commonly, anomalous left main coronary artery from right (anterior) sinus of Valsalva (n=65) and anomalous right coronary artery from the left sinus (n=16). ARVC indicates arrhythmogenic right ventricular cardiomyopathy; AS, aortic stenosis; CA, coronary artery; CAD, coronary artery disease; CM, cardiomyopathy; CV, cardiovascular; HCM, hypertrophic cardiomyopathy; LAD, left anterior descending coronary artery; MVP, mitral valve prolapse; and WPW, Wolff-Parkinson-White.

Chain of survival


For medical professionals, the time is now to stimulate a greater research effort. The tragic events that take place on the pitch should, in the end, motivate all those involved to contribute to our own virtuous cycle of research, with the same zeal and ambition as the competitive athlete.

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